Lung cancer stigma: A ten-year look at patient and oncologist attitudes about lung cancer.

Abstract

11619 Background: The presence of lung cancer stigma is well documented and has been shown to impact the care and treatment of lung cancer survivors (Tod et al. 2008; Carter-Harris et al. 2014). In the past decade, there has been considerable research progress in lung cancer but it is unknown if the level of stigma has changed and how that affects patient care. Methods: 205 oncologists who treat lung cancer, 208 patients with lung cancer, and 1001 members of the general public were surveyed with the same survey instrument from a 2008 survey (Weiss et al. 2014) plus 5-15 additional questions at the end. The survey was carried out with identical methodology by phone and online between June 6 and July 26, 2018. Statistical analysis was performed comparing 2008 and 2018 datasets using paired t-tests if normally distributed or Mann-Whitney U tests for continuous data and Chi-squared or Fisher’s exact test for categorical data. Results: In 2018, significantly more oncologists feel they have adequate treatment options for metastatic lung cancer (67% vs 36%, p < 0.001) and the majority of patients report being satisfied with their medical care (87%) and treatment options (71%). Despite these advances, there was a non-significant increase in oncologists indicating both that there is a stigma associated with lung cancer (68% in 2018 vs 60% in 2008) and that patients blame themselves (67% vs 57%). Significantly more patients felt that there was a stigma associated with having lung cancer (70% vs. 54%, p < 0.001). In addition, 57% of oncologists indicated that patients with different cancers are thought about, approached, or handled differently, similar to 2008. Lung cancer patients were most frequently cited as treated differently. In 2018, 40% of patients agreed with the statement “patients with lung cancer are treated differently by doctors and nurses” compared to 26% a decade ago (p = .01). Both groups felt the most common way patients were treated differently was “received less sympathy from medical staff.” Conclusions: After a decade of research progress in lung cancer, stigma surrounding the disease remains a critical problem even in a healthcare setting. Patients are perceiving stigma at higher levels and oncologists are not reporting any improvement. This work underscores the need to address stigma with proactive multilevel approaches including the need for medical providers to practice empathic communication.