Knowledge Gaps Persist in Patient Understanding of Skin Cancer–Related Terms

Patient understanding of commonly used skin cancer–related terms varies by both demographic subgroup and terminology, highlighting the need for dermatologists to use clearer, more accessible language during clinical visits, according to a research letter recently published in JAMA Dermatology.¹

Communication Barriers in Dermatologic Care

The researchers emphasized that effective patient-physician communication is essential to high-quality health care because of its impact on health outcomes. To assess communication gaps, they conducted a survey study evaluating patient understanding of commonly used cutaneous skin cancer–related terms and phrases, as well as factors influencing comprehension.

Specifically, an anonymous, voluntary survey was administered to patients receiving treatment at general dermatology clinics at Beth Israel Deaconess Medical Center in Boston, Massachusetts, during a 2-week period in May 2025. In addition to collecting demographic information, the survey assessed comprehension of 13 common skin cancer–related terms using multiple-choice questions with 1 correct answer.

After adjusting for all demographic variables, the researchers used multivariable linear regression to evaluate associations between patient characteristics and the mean percentage of correct responses, representing overall comprehension.

Patient Comprehension Varies by Demographics, Terminology

Of the 182 eligible patients, 166 (90.4%) completed the survey. Most participants were female (n = 91; 54.8%), White (n = 135; 81.3%), and aged 60 or older (n = 82; 49.4%). Nearly half of the study population had a college or university education (n = 76; 45.8%), while more than half reported more than 5 prior dermatology visits (n = 93; 56.0%).

Knowledge scores varied across demographic subgroups, with participants holding graduate degrees and those with more than 5 prior dermatology visits demonstrating the highest scores. By age, patients between the ages of 18 and 29 had significantly lower scores than those aged 60 or older (β = –17.88; 95% CI, –28.37 to –7.39; P < .001). However, the researchers noted that even patients aged 60 or older and those with more than 5 prior dermatology visits had average accuracy rates below 75%, suggesting that routine dermatology exposure alone may not be sufficient for full comprehension.

“This reinforces the need for improved patient education strategies during clinical visits,” the authors wrote.

Regarding individual terms, most participants correctly identified topical (n = 157; 95.2%), skin biopsy (n = 155; 95.1%), benign (n = 145; 89.0%), malignant (n = 141; 86.5%), melanoma (n = 138; 84.7%), and metastatic (n = 134; 82.2%). Recognition rates were lower for basal cell carcinoma (n = 114; 70.0%), excision (n = 112; 67.9%), pathology results (n = 109; 66.1%), and clear margins (n = 104; 64.2%). The least commonly recognized terms were squamous cell carcinoma (n = 98; 59.4%), dysplastic nevus (n = 35; 21.6%), and actinic (n = 22; 13.6%).

“These findings are concerning and highlight the need for dermatologists to use clearer, more accessible language when discussing skin cancer diagnoses, treatments, and risks,” the investigators wrote.

Future Directions for Improving Health Literacy

The researchers acknowledged several limitations, including the single-site study design and the absence of data on family history and reasons for dermatology visits, which may have influenced term familiarity. They also noted that prior research suggests dermatologic health literacy varies by race and social determinants of health²; however, because most participants were White, meaningful conclusions in this area could not be drawn.¹ Considering these limitations, the researchers identified opportunities for further research.

“Future research should explore interventions to improve patient education and examine whether tailored language improves understanding and engagement in dermatologic care,” the authors concluded.

References

1. Khang J, Karatas E, Martinez R, McGee JS, Brag K. Patient comprehension of skin cancer–related terminology. JAMA Dermatol. Published online December 10, 2025. doi:10.1001/jamadermatol.2025.4756
2. Bowers S, Chang AY. The social determinants of health and their impact on dermatologic health, part 1: the social determinants of health and their dermatologic implications. Dermatol Clin. 2023;41(2):309-316. doi:10.1016/j.det.2022.10.002