MS11.01 Identifying Consequences of Stigma on Lung Cancer Care Delivery and Patient Outcomes

Abstract

Lung cancer stigma (the experience and internalization of negative appraisal and devaluation from others) is a formidable barrier to fulfilling the promise of high quality patient care and reduced lung cancer burden. Attention to the robust causal connection between smoking and lung cancer, although crucial for tobacco control, may have unintended consequences that generate blaming responses and biased negative perceptions toward lung cancer patients. Lung cancer stigma can have far-reaching, deleterious effects that range from reduced involvement in prevention and early detection interventions, negative psychosocial impact, impaired patient-clinician communication, inadequate access to diagnosis and treatment, and limited funding and public support for lung cancer research and care. The goals of this presentation are to describe the nature of lung cancer stigma and highlight research that addresses consequences of stigma on lung cancer care delivery and patient outcomes. The presentation also focuses on multilevel interventional opportunities to mitigate the negative effects of stigma. Based on both qualitative and quantitative assessment, our team has identified three primary components of patient-reported lung cancer stigma: perceived stigma, internalized stigma, and constrained disclosure (Hamann et al., 2018). Cross-sectional data indicate associations between stigma and impaired patient/provider communication, higher rates of depressive symptoms, and reduced engagement in care among lung cancer patients. Recent work has also demonstrated potential provider-level stigma toward lung cancer patients, with implications for treatment decisions and other aspects of lung cancer care. Interventional opportunities include patient-based education and counseling to address the psychosocial and behavioral consequences of lung cancer stigma. Focusing on provider communication training also represents a promising opportunity to reduce stigma toward lung cancer patients. psychosocial, care outcomes, stigma