Medical terms that oncologists and other clinicians use are sometimes misunderstood by patients, according to a study published in JAMA Network Open.

Roughly 21% of patients surveyed did not understand that the phrase “your tumor is progressing” is negative news, and 34% did not understand that “positive lymph nodes” suggest the cancer is spreading.

The study included 215 patients who did not work in or have training in the medical field. They completed a verbal or written survey to demonstrate their understanding of medical jargon. 

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The patients had a median age of 42 years, and 63% were women. Most had a bachelor’s degree (32.3%) or graduate/professional degree (32.3%), with the remaining having some college experience (16.1%), an associate’s degree (8.3%), high school diploma or GED (9.2%), or some high school experience (1.4%).

Nearly all participants (96.3%) understood that negative screening results suggest no cancer was detected. 

Most patients (79.1%) understood that “your tumor is progressing” is bad news, and 66.5% understood that “positive lymph nodes” mean the cancer is spreading.  

Most patients (79.5%) understood that an “unremarkable” chest x-ray is good news, but only 20.5% of patients understood that “impressive” radiography findings indicate bad news.

Few patients understood the terms “febrile” (9.3%) and “occult infection” (1.9%) or the abbreviation “NPO” (11.2%). However, 75.3% understood what “nothing by mouth” means. 

“These findings suggest that several common phrases are misunderstood when used in a medical setting, with the interpreted meaning frequently the exact opposite of what was intended,” the researchers concluded.


Gotlieb R, Praska C, Hendrickson MA, et al. Accuracy in patient understanding of common medical phrases. JAMA Netw Open. Published online November 30, 2022. doi:10.1001/jamanetworkopen.2022.42972