Perceived stigma and its correlates among Asian patients with advanced cancer: A multi‐country APPROACH study. Issue 6 (28th January 2022)

• Record Type: Journal Article
• Authors: Teo, Irene; Bhaskar, Adithya; Ozdemir, Semra; Malhotra, Chetna; Hapuarachchi, Thushari; Joad, Anjum Khan; Manalo, Maria Fidelis; Mariam, Lubna; Ning, Xiaohong; Palat, Gayatri; Rahman, Rubayat; Tuong, Pham Nguyen; Finkelstein, Eric A.
• Is Part Of: Psycho-oncology. Volume 31:Issue 6(2022)
• Page Start: 938
• Page End: 949
• Publication Date: 2022-01-28
• Subjects: Asia -- cancer -- psycho‐oncology -- stigma -- treatment preferences; Cancer -- Psychological aspects -- Periodicals; Cancer -- Social aspects -- Periodicals; Neoplasms -- psychology -- Periodicals; 616.9940019
• DOI: 10.1002/pon.5882
• Languages: English
• ISSNs: 1057-9249

Abstract

Abstract: Objectives: Perceived cancer‐related stigma can affect mental health and potentially treatment choices for patients with cancer. Nevertheless, perceived stigma is not very well understood in Asia. This study investigated across six developing Asian countries: (1) the prevalence of perceived stigma among advanced cancer patients, (2) its risk factors, and (3) its association with patient treatment preferences. Methods: This cross‐sectional study recruited patients receiving oncology care across major hospitals in Bangladesh, China, India, Philippines, Sri Lanka and Vietnam. Participants ( N = 1358) were adults diagnosed with stage IV metastatic solid cancer who completed self‐reported surveys. Multi‐variable logistic regression and ordered logit models examined the associations with perceived stigma and variables of interest. Results: Across the countries, 35%, 95% CI [32%, 38%] of patients reported experiencing at least one facet of cancer‐related stigma often or always, while 60% [57%, 63%] reported it occurring occasionally. Top‐endorsed facets of perceived stigma across the Asian countries suggest a distinct pattern. Having knowingly engaged in health‐risk behaviours ( OR = 2.03–2.24, 95% CI [1.14–1.19, 3.43–4.41]), unemployment (2.64 [1.67, 4.19]) and body image change (1.57 [1.00, 2.45]) were associated with higher odds of perceived stigma, while time mitigated perceived stigma (0.49–0.65 [0.30–0.45, 0.76–0.92]). Perceived stigma was associated with lower odds of preference for life‐extending treatments, although the associations did not hold up in the adjusted model. Conclusions: Perceived stigma is unique among Asian advanced cancer patients. Stigma is important to assess and address, taking into consideration the various sociodemographic, clinical and psychological factors of cancer patients.