Patients often misunderstand common skin cancer terms, survey finds

Dermatologists may assume that their patients know what is meant by commonly used terms such as “clear margins” or “dysplastic nevus,” but a new survey suggests that assumption is often wrong.

In a research letter, published December 2025 in JAMA Dermatology, patients showed uneven and sometimes poor comprehension of skin cancer-related terminology frequently used in routine care. The study was led by Katherine Brag, M.D. at the Department of Dermatology at Beth Israel Deaconess Medical Center and Harvard Medical School, Boston.

Effective communication is central to quality healthcare, particularly in oncology, where diagnoses and treatment decisions hinge on nuanced information. Skin cancer is among the most common malignancies in the United States, and dermatology visits often involve discussions of biopsies, pathology reports and cancer risk. Yet little research has examined how well patients actually understand the language used in those conversations.

Brag and colleagues conducted an anonymous survey of patients seen in general dermatology clinics at Beth Israel Deaconess over a two-week period in May 2025. Patients presenting for cosmetic visits, those requiring interpreters and those with cognitive deficits were excluded. Among 182 eligible patients, 166 completed the survey, which tested understanding of 13 common skin cancer-related terms using multiple-choice questions. Multivariable analyses adjusted for demographic factors examined overall comprehension as measured by the percentage of correct responses.

Knowledge varied considerably by age, education and prior dermatology experience. Patients ages 18 to 29 years scored significantly lower than those 60 years or older, while participants with graduate degrees and those with more than five prior dermatology visits had the highest scores. Still, even in these groups, average accuracy remained below 75%.

Overall, greater knowledge accuracy was associated with older age, higher education, direct involvement in patient care, and more frequent dermatology visits. Lower scores were observed among younger adults, individuals without healthcare roles, and some racial and ethnic minority groups. Women scored higher than men; results for nonbinary participants were not analyzed due to very small numbers.

Understanding also varied widely by term. Nearly all respondents correctly defined “skin biopsy” and “topical,” but only 13.6% understood “actinic,” and just 21.6% correctly identified the meaning of “dysplastic nevus.” About one-third of participants did not understand “clear margins” or “pathology results,” and a sizable minority did not recognize melanoma, squamous cell carcinoma or basal cell carcinoma as types of cancers.

The findings highlight persistent gaps in skin cancer literacy, even among patients regularly exposed to dermatologic care. The authors note that unclear terminology may limit patients’ ability to grasp cancer risk and long-term implications of their diagnoses, emphasizing the need for more accessible language and improved education strategies during clinic visits.