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We conducted this study to reveal the historical changes of parents' perception of diagnosis disclosure of childhood cancer to children. Parents having school children were recruited for questionnaire surveys conducted in 1998, 2008 and 2018. They were questioned about their perception of cancer, cancer diagnosis disclosure to children and advantages and disadvantages of the diagnosis disclosure. The historical changes were analyzed by comparing the responses at each survey with a Chi-square test and a residual analysis. Parents perceiving “cancer is incurable” decreased from 40.0% (an adjusted standardized residual [ASR] = 12.002 P

BACKGROUND Social awareness on cancer can be changed with cancer education and proper distribution of cancer information. This study addressed the current situation and historical change of children's perception of cancer. METHODS Questionnaire surveys were conducted among healthy school children aged 10 to 15 years in 2008 and 2018. Knowledge of cancer was questioned and compared with that of asthma, tuberculosis or measles. Furthermore, the children were asked their resources of health information. RESULTS The numbers of participants and collection rates were 438 and 63.9% in 2008, and 320 and 44.7% in 2018. Children's perception of cancer was significantly changed in the last decade. The proportion of respondents answering "cancer affects children" was changed from 78.3 to 89.5% (P=0.0001), "cancer is preventable", from 42.0 to 49.7% (P=0.0425) and "cancer is curable", from 52.4 to 66.0% (P=0.0003). Significantly more junior high school students answered that cancer is preventable than elementary school children in 2018 (55.9 vs. 42.7%, P=0.0028). The major resources of information on health were television, parents and books. The proportion of children choosing the Internet significantly increased from 15.3 to 47.8% (P

The practice of cancer diagnosis disclosure to children has been changed with the times. The regulations of clinical trials in the 2000s might change the practice in Japan. However, the perspective of this topic among children and adults has not been investigated in detail. We studied changes in the practice of information sharing with children with cancer at pediatric cancer centers and the perspective of cancer diagnosis disclosure to children among school children, their parents and pediatric oncologists in the last 20 years by comparing the results of questionnaire surveys conducted in 1998, 2008 and 2018. This study revealed that the performing rate has increased with the times, but the institutions actively performing for children aged 7–9 years were 36.4% even in the 2018 survey. More than 70% of children wished diagnosis disclosure if they suffer from cancer in the series of surveys, while the ratio of parents who tell cancer diagnosis to their children hovered at 34.5 to 53.7% (p