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Cancer-Related Stigma in Malawi: Narratives of Cancer Survivors

Stigma is an impediment across the cancer care continuum, leading to delayed presentation to care, elevated morbidity and mortality, and reduced quality of life. The goal of this study was to qualitatively examine the drivers, manifestations, and impacts of cancer-related stigma among individuals wh...

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Autores principales: Watt, Melissa H., Suneja, Gita, Zimba, Chifundo, Westmoreland, Katherine D., Bula, Agatha, Cutler, Lux, Khatri, Abhilasha, Painschab, Matthew S., Kimani, Stephen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166375/
https://www.ncbi.nlm.nih.gov/pubmed/36795989
http://dx.doi.org/10.1200/GO.22.00307
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author Watt, Melissa H.
Suneja, Gita
Zimba, Chifundo
Westmoreland, Katherine D.
Bula, Agatha
Cutler, Lux
Khatri, Abhilasha
Painschab, Matthew S.
Kimani, Stephen
author_facet Watt, Melissa H.
Suneja, Gita
Zimba, Chifundo
Westmoreland, Katherine D.
Bula, Agatha
Cutler, Lux
Khatri, Abhilasha
Painschab, Matthew S.
Kimani, Stephen
author_sort Watt, Melissa H.
collection PubMed
description Stigma is an impediment across the cancer care continuum, leading to delayed presentation to care, elevated morbidity and mortality, and reduced quality of life. The goal of this study was to qualitatively examine the drivers, manifestations, and impacts of cancer-related stigma among individuals who received cancer treatment in Malawi, and to identify opportunities to address stigma. METHODS: Individuals who had completed treatment for lymphoma (n = 20) or breast cancer (n = 9) were recruited from observational cancer cohorts in Lilongwe, Malawi. Interviews explored the individual's cancer journey, from first symptoms through diagnosis, treatment, and recovery. Interviews were audio-recorded and translated from Chichewa to English. Data were coded for content related to stigma, and thematically analyzed to describe the drivers, manifestations, and impacts of stigma along the cancer journey. RESULTS: Drivers of cancer stigma included beliefs of cancer origin (cancer as infectious; cancer as a marker of HIV; cancer due to bewitchment), perceived changes in the individual with cancer (loss of social/economic role; physical changes), and expectations about the individual's future (cancer as death sentence). Cancer stigma manifested through gossip, isolation, and courtesy stigma toward family members. The impacts of cancer stigma included mental health distress, impediments to care engagement, lack of cancer disclosure, and self-isolation. Participants suggested the following programmatic needs: community education about cancer; counseling in health facilities; and peer support from cancer survivors. CONCLUSION: The results highlight multifactorial drivers, manifestations, and impacts of cancer-related stigma in Malawi, which may affect success of cancer screening and treatment programs. There is a clear need for multilevel interventions to improve community attitudes toward people with cancer, and to support individuals along the continuum of cancer care.
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spelling pubmed-101663752023-05-09 Cancer-Related Stigma in Malawi: Narratives of Cancer Survivors Watt, Melissa H. Suneja, Gita Zimba, Chifundo Westmoreland, Katherine D. Bula, Agatha Cutler, Lux Khatri, Abhilasha Painschab, Matthew S. Kimani, Stephen JCO Glob Oncol ORIGINAL REPORTS Stigma is an impediment across the cancer care continuum, leading to delayed presentation to care, elevated morbidity and mortality, and reduced quality of life. The goal of this study was to qualitatively examine the drivers, manifestations, and impacts of cancer-related stigma among individuals who received cancer treatment in Malawi, and to identify opportunities to address stigma. METHODS: Individuals who had completed treatment for lymphoma (n = 20) or breast cancer (n = 9) were recruited from observational cancer cohorts in Lilongwe, Malawi. Interviews explored the individual's cancer journey, from first symptoms through diagnosis, treatment, and recovery. Interviews were audio-recorded and translated from Chichewa to English. Data were coded for content related to stigma, and thematically analyzed to describe the drivers, manifestations, and impacts of stigma along the cancer journey. RESULTS: Drivers of cancer stigma included beliefs of cancer origin (cancer as infectious; cancer as a marker of HIV; cancer due to bewitchment), perceived changes in the individual with cancer (loss of social/economic role; physical changes), and expectations about the individual's future (cancer as death sentence). Cancer stigma manifested through gossip, isolation, and courtesy stigma toward family members. The impacts of cancer stigma included mental health distress, impediments to care engagement, lack of cancer disclosure, and self-isolation. Participants suggested the following programmatic needs: community education about cancer; counseling in health facilities; and peer support from cancer survivors. CONCLUSION: The results highlight multifactorial drivers, manifestations, and impacts of cancer-related stigma in Malawi, which may affect success of cancer screening and treatment programs. There is a clear need for multilevel interventions to improve community attitudes toward people with cancer, and to support individuals along the continuum of cancer care. Wolters Kluwer Health 2023-02-16 /pmc/articles/PMC10166375/ /pubmed/36795989 http://dx.doi.org/10.1200/GO.22.00307 Text en © 2023 by American Society of Clinical Oncology https://creativecommons.org/licenses/by/4.0/Licensed under the Creative Commons Attribution 4.0 License: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/)
spellingShingle ORIGINAL REPORTS
Watt, Melissa H.
Suneja, Gita
Zimba, Chifundo
Westmoreland, Katherine D.
Bula, Agatha
Cutler, Lux
Khatri, Abhilasha
Painschab, Matthew S.
Kimani, Stephen
Cancer-Related Stigma in Malawi: Narratives of Cancer Survivors
title Cancer-Related Stigma in Malawi: Narratives of Cancer Survivors
title_full Cancer-Related Stigma in Malawi: Narratives of Cancer Survivors
title_fullStr Cancer-Related Stigma in Malawi: Narratives of Cancer Survivors
title_full_unstemmed Cancer-Related Stigma in Malawi: Narratives of Cancer Survivors
title_short Cancer-Related Stigma in Malawi: Narratives of Cancer Survivors
title_sort cancer-related stigma in malawi: narratives of cancer survivors
topic ORIGINAL REPORTS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166375/
https://www.ncbi.nlm.nih.gov/pubmed/36795989
http://dx.doi.org/10.1200/GO.22.00307
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