Cancer stigma and cancer screening attendance: a population based survey in England

Abstract

Background Cancer-related stigma attracts considerable research interest, but few studies have examined stigmatisation in the healthy population. Qualitative studies suggest that stigma can discourage people from attending cancer screening. We aimed to quantify the prevalence and socio-demographic patterning of cancer stigma in the general population and to explore its association with cancer screening attendance. Methods In 2016, 1916 adults aged 18–70 years took part in home-based interviews in England. Measures assessed demographic characteristics, self-reported screening uptake for cervical ( n = 681), breast ( n = 326) and colorectal cancer ( n = 371), and cancer stigma. Cancer stigma was measured with the validated Cancer Stigma Scale which assesses six subdomains ( Severity , Personal Responsibility, Awkwardness, Avoidance, Policy Opposition, and Financial Discrimination ), from which a mean score was calculated . Logistic regression analyses examined the association between cancer stigma and having been screened as recommended versus not. Results Levels of cancer stigma were low, but varied across the six subdomains. Items regarding the severity of a cancer diagnosis attracted the highest levels of agreement (30–51%), followed by statements about the acceptability of making financial decisions on the basis of a cancer diagnosis such as allowing banks to refuse a mortgage (16–31%) and policy opposition statements such as not having a responsibility to provide the best possible care for cancer patients (10–17%). A similar proportion anticipated feeling awkward around someone with cancer (10–17%). Only 8–11% agreed with personal responsibility statements, such as that a person with cancer is to blame for their condition, while 4–5% of adults anticipated avoiding someone with cancer. Stigma was significantly higher in men ( p < .05) and in those from ethnic minority backgrounds ( p < .001). Higher cancer stigma was associated with not being screened as recommended for all three screening programmes (cervical: adjusted OR 1.59, 95% CI 1.15–2.20; breast: adjusted OR = 1.97, 95% CI 1.17–3.32; colorectal: adjusted OR = 1.59, 95% CI 1.06–2.38). Conclusions Cancer stigma is generally low, but some aspects of stigma are more prevalent than others. Stigma is more prevalent in certain population subgroups and is negatively associated with cancer screening uptake. These benchmark findings may help track and reduce cancer stigma over time. Electronic supplementary material The online version of this article (10.1186/s12885-019-5787-x) contains supplementary material, which is available to authorized users.

Breast cancer patient advocacy: A qualitative study of the challenges and opportunities for civil society organizations in low‐income and middle‐income countries

“…Although stigma has been shown to negatively impact health‐seeking behavior, 1,14 participants described how stigma also hinders their activities due to negative attitudes and suspicion associated with cancer, advocacy, and CSOs. Survivors play a critical role in raising awareness, changing beliefs, and driving change in their communities.…”

Faecal occult blood test and colonoscopy use in Portugal: Results from the National Health Survey 2014

“…Having such information would allow for direct comparison with the annual reports from the organised screening programmes in Portugal, 7,8 and with other studies that have evaluated screening programmes at the European level. 15,20,22,23 Nevertheless, even when time trends are computed, the original data are based on consecutive cross-sectional surveys, 13,14,18,20 which limits the establishment of a causal relation between the use of colorectal cancer screening and independent factors due to the lack of the time sequence.…”

Counteracting Chemoresistance with Metformin in Breast Cancers: Targeting Cancer Stem Cells

“…While modern-day diagnostics and awareness programs have increased the chances for the early detection of the disease, it is still more likely that the disease comes to light only during its later stages, since the early stages remain asymptomatic, and often, in addition to the cultural stigma that limits potential patients from seeking medical care and advice, most of them have limited access to medical care or screening programs and pose a financial burden in the absence of health insurance coverage [ 18 , 19 , 20 ]. In some instances, the efficacy of the therapeutic intervention is compromised when the patients undergoing therapy are unable to absorb the drug adequately or at times rapidly metabolize and excrete the drug, leading to less than adequate levels of the drug in the body that are required for its anti-tumor effect [ 21 ].…”