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Worth Attention RCT

Calling it “radiation therapy” reduced treatment preference compared with “radiotherapy”

In a randomized US survey, “radiation therapy” reduced selection of the same treatment by 8.3 percentage points versus “radiotherapy.”

RadOncToday · ·1 min read

KEY POINTS

  • This preregistered parallel-group experiment randomized US adults to an identical hypothetical early-stage head and neck cancer scenario offering two clinically equivalent options: surgery or radiation treatment. The only difference was whether the latter was called “radiotherapy” or “radiation therapy.”
  • Of 1,638 randomized participants, 1,531 were included in the final analysis: 783 saw “radiotherapy” and 748 saw “radiation therapy.” Mean age was 46.4 years, 51.2% were women, and recruitment was structured to approximate US age, sex, and ethnic demographics.
  • Radiation treatment was selected by 70.9% of participants exposed to “radiotherapy” versus 62.6% exposed to “radiation therapy,” an absolute reduction of 8.3 percentage points (95% CI −13.0 to −3.6; p<0.001).
  • The terminology effect remained after adjustment for health literacy, cancer history, radiation-related worry, attitudes toward nuclear technology, and political variables (adjusted OR 0.68, 95% CI 0.54–0.84; p<0.001).
  • “Radiation therapy” generated greater anticipated anxiety (5.11 versus 4.71 on a seven-point scale), lower perceived safety (4.28 versus 4.70), and greater perceived aggressiveness (5.34 versus 4.84); all adjusted comparisons had p<0.001. Ratings of surgery were essentially unchanged between groups.
  • The effect was not meaningfully modified by baseline radiation worry or political ideology. Participants exposed to “radiation therapy” also reported lower certainty about their decision, suggesting that the framing affected both preference and confidence.
  • This was an online survey of the general public using a hypothetical diagnosis, without real treatment consequences, physician counselling, individualized toxicity information, or actual patients facing a cancer decision. It therefore demonstrates a terminology effect, not improved clinical decision-making from renaming treatment.

CLINICAL TAKEAWAY

The language used to introduce radiotherapy may measurably influence fear, perceived safety, and willingness to accept treatment. The finding is relevant to patient communication and public-facing materials, but one hypothetical survey is insufficient to mandate universal terminology changes without testing the effect in actual clinical consultations.

SOURCE

International Journal of Radiation Oncology, Biology, Physics