Although Japanese physicians historically have not disclosed @entity5 diagnoses to @entity1 , pressures upon physicians to disclose have increased in recent years. We questioned physicians practicing at a private medical hospital in rural Japan about their current approach to @entity5 disclosure. We compared their responses with responses of physicians in a 1991 study conducted in Japan, and two studies conducted in the United States, in 1961 and in 1977. Seventy-seven clinically active physicians with experience treating @entity5 @entity1 responded (73% response rate). Forty percent of respondents reported usually telling @entity1 of a @entity5 diagnosis, over three times more than the 13% who reported such a policy in Japan in 1991. Physicians were significantly more likely (P < 0.001) to make exceptions than physicians in the previous Japanese study, and physicians in the previous U.S. studies. Respondents reported considering more factors in deciding whether to tell than @entity1 in the 1977 U.S. study. Factors predicting an increased probability of disclosure included age (in a hyperbolic relationship), improved prognosis, @entity0 , and social status and religion (by a minority of respondents). Increase in a substitute decision maker's age was predictive for physicians not to involve the @entity1 in decision-making. Most respondents reported their disclosure policy is based on clinical experience. More respondents indicated a likelihood of changing in the future than respondents in the previous U.S. studies. These data suggest Japanese physicians are moving away from a rigid policy of nondisclosure to a policy of selective disclosure, but they have not adopted universal @entity5 disclosure as practiced in many Western countries. Since young age and advanced age predicted self-reports of not disclosing @entity5 diagnoses, these data raise the question of whether nondisclosure by age groups represents age discrimination or compassionate medical care tailored to individual @entity1 needs.

XXXX in Japan: historical comparisons, current practices.

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity1 :: ('9606', 'Species') :: ['participants', 'patients', 'patient', 'person'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast or cervical cancer']
@entity5 :: (MESH:D009369,Disease) :: ['Cancer disclosure']
