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Background  Progress in advance care planning (ACP) in China has been hindered for decades compared with other countries.    Aims  To describe knowledge of ACP, end‐of‐life (EOL) care preferences and the predictors of patients' preference for ACP, as well as who should mention ACP among Chinese lung cancer patients.    Methods  Questionnaire‐based interviews were carried out. Two hundred and fifty‐eight lung cancer patients were recruited when first admitted to Tongji Hospital from October 2017 to November 2018. Social‐demographic factors, which might influence patients' preference on ACP decisions and who should mention ACP, were evaluated using multivariate logistic regression analysis.    Results  A total of 91.1% ( n  = 235) of patients favoured  ACP  on  EOL  issues. One hundred and sixty (60%) patients wanted to make  EOL  decisions on their own. Only 10% of patients were familiar with advance directions. Eighty‐two (31.8%) patients were familiar with do not resuscitate/do not intubate ( DNR / DNI ) directions.  ACP  was not mentioned in 92.2% of patients. Gender (male,  OR  = 4.87 (2.16–5.83)), tumour stage (Stage  III ,  OR  = 0.108 (0.06–0.51); Stage  IV ,  OR  = 1.780 (1.02–2.11)) and number of children (every increase in the number of children,  OR  = 0.267 (0.09–0.93)) were the significant predictors of preference for autonomous  ACP . Female patients and patients currently receiving treatment are 2.743 and 1.8 times, respectively, more willing to need  ACP  initiated by doctors.    Conclusions  Chinese patients showed preferences towards  ACP , but with inadequate knowledge. More assistance is needed with  ACP  for those patients, especially for females, patients with one child and those with early stage lung cancer. For female patients and patients receiving treatment, doctors may initiate  ACP  dialogue first.

Discussion of advance care planning on end‐of‐life decisions with lung cancer patients in Wuhan, China: attitude, timing and future directions