{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:36:33Z","timestamp":1787070993484,"version":"build-2736575974"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"Abstract<\/jats:title>\n \n Background and Aims:<\/jats:title>\n Collusion, the practice of concealing a diagnosis or prognosis from a close relative to prevent emotional distress, is a complex issue in cancer care. This study aimed to estimate the prevalence of collusion among cancer patients and identify the associated factors, including educational status, time since diagnosis, and prognosis.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This 6-month cross-sectional study recruited 121 consenting cancer patients (aged >18 years) via convenient sampling at a tertiary care center in South India. Patients with psychiatric conditions or communication difficulties were excluded. The data were collected through qualitative interviews using a modified collusion questionnaire.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The overall prevalence of collusion was 26.4%. Significant associations were found with educational status (\n P<\/jats:italic>\n = 0.024), with collusion being highest among those with primary education (40.7%) and lowest in postgraduates (12.2%). Collusion was also significantly associated with time since diagnosis (\n P<\/jats:italic>\n < 0.001), being 88.9% within 1 month and decreasing to 54.2% by 6 months. Caregivers frequently colluded (\n P<\/jats:italic>\n < 0.001) even when the disease was considered partly curable. Among the collusion positive cases, 96.9% of the caregivers were unwilling to discuss the diagnosis and 87.5% unwilling to inform patients about the disease\u2019s course or outcome.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Collusion is prevalent in cancer patients, particularly among those with lower education levels and in the early postdiagnosis period. Caregivers often withhold comprehensive information, highlighting a need for improved communication strategies in oncology.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aam.aam_215_25","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T11:00:10Z","timestamp":1757415610000},"page":"847-852","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Collusion in Cancer Care: An Investigation into its Facets at a Tertiary Care Center in South India"],"prefix":"10.4103","volume":"25","author":[{"given":"Swatilaxmi","family":"Rajan","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Malankara Orthodox Syrian Church Medical College, Ernakulam, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini Miriam","family":"Ipe","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Malankara Orthodox Syrian Church Medical College, Ernakulam, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suneesh Soman","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Oncology, Malankara Orthodox Syrian Church Medical College, Ernakulam, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Philip","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Malankara Orthodox Syrian Church Medical College, Ernakulam, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaloo","family":"Ipe","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Malankara Orthodox Syrian Church Medical College, Ernakulam, Kerala, 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