Kilbridge, K. L. et al. Lack of comprehension of common prostate cancer terms in an underserved population. J. Clin. Oncol. 27, 2015–2021 (2009).

Patients' comprehension of many medical terms is much worse than researchers and physicians expect, conclude the authors of a study investigating understanding of common prostate cancer terms in a small population of African-American men in low-income areas. “In an effort to explain medical terms, physicians often use more medical terms—we found that patients feel more comfortable using colloquial words for bodily functions. This improves understanding and is not considered offensive, as many physicians think,” observes lead author Kerry Kilbridge.

The study of 105 men evaluated comprehension of medical terms describing sexual, urinary and bowel function. Understanding of words commonly used when obtaining informed consent for prostate cancer treatment or when measuring the outcome of therapy was very limited. Fewer than 50% understood terms such as 'erection', only 5% knew what 'incontinence' was, and a quarter had no idea what 'bowel habits' referred to. One patient interviewed thought it meant homosexual anal sex. Miscomprehension of terms, particularly compound words such as 'rectal urgency', was correlated with low literacy levels.

“The words that doctors use often don't mean much to everyday people and, conversely, the colloquial terms that physicians worry about using may, in fact, represent the best way we have to communicate with our patients,” says Kilbridge. The researchers now aim to adapt standard prostate-specific quality-of-life instruments to make them more accessible to underserved patients with poor literacy skills. “I'm also keenly interested in trying to develop rapid methods of identifying patients most likely to have low literacy skills and poor comprehension of medical terms—without administering a health literacy test,” she reports.