Abstract
IntroductionCancer contributes to significant illness burden in South Africa, with delayed diagnosis resulting from limited knowledge of cancer, lack of biomedical treatment and stigma. This study examines ways in which people are identified as having cancer through perspectives of traditional healing or the biomedical model. Additionally, we sought to understand the stigma associated with cancer, including stereotypes, anticipated discrimination and coping styles.MethodsLivestrong Foundation conducted 11 semi-structured focus groups with key community stakeholders in three South African townships. Interviews examined the negative consequences of being labeled with a cancer diagnosis as well as causes of, possible prevention of and barriers and methods to improve access to cancer treatment. Analyses were completed using directed content analysis.ResultsRevealed three main labeling mechanisms: physical appearance of perceived signs/symptoms of cancer, diagnosis by a traditional healer, or a biomedical diagnosis by a Western physician. Being labeled led to anticipated discrimination in response to prevalent cancer stereotypes. This contributed to delayed treatment, use of traditional healers instead of biomedical treatment and secrecy of symptoms and/or diagnosis. Further, perceptions of cancer were commonly conflated with HIV/TB owing to prior educational campaigns.ConclusionOur study deepens the understanding of the cancer labeling process in South Africa and the resulting negative effects of stigma. Future anti-stigma interventions should partner with traditional healers due to their respected community status and consider how previous health interventions may significantly impact current understandings of illness.
Highlights
Cancer contributes to significant illness burden in South Africa, with delayed diagnosis resulting from limited knowledge of cancer, lack of biomedical treatment and stigma
The American Cancer Society [2] identified that the majority of deferred cancer diagnoses in Africa resulted from limited awareness of early signs of cancer, lack of biomedical screening and stigma
Results compelled the Livestrong Foundation to conduct a pilot anti-stigma campaign in South Africa from 20102012. Prior to this cancer education campaign, Livestrong Foundation conducted a series of qualitative interviews and focus groups with key community stakeholders to understand cultural conceptions of cancer stigma which we report upon here
Summary
Cancer contributes to significant illness burden in South Africa, with delayed diagnosis resulting from limited knowledge of cancer, lack of biomedical treatment and stigma. Being labeled led to anticipated discrimination in response to prevalent cancer stereotypes This contributed to delayed treatment, use of traditional healers instead of biomedical treatment and secrecy of symptoms and/or diagnosis. Social consequences of being labeled with a cancer diagnosis (e.g. shame) may deter use of biomedical screening, resulting in treatment delays [6,7,8]. Public education campaigns to increase knowledge and decrease stigma are crucial in promoting prevention and treatment of cancer in South Africa [9, 10]. Successful strategies may include partnering with traditional healers This has been used to increase diffusion of information regarding HIV/AIDS awareness. Our findings may inform interventions aimed to raise awareness, increase biomedical screenings and treatment for those diagnosed with cancer
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