Socio-Economic Factors Associated with Cancer Stigma among Apparently Healthy Women in Semi-urban Nepal.

Cancer is the primary cause of death globally, and despite the significant advancements in treatment and survival rates, it is still stigmatized in many parts of the world. However, there is limited public health research on cancer stigma among general population (non-patient) women in Nepal. Therefore, this study aims to determine the prevalence of cancer stigma and its associated factors in this group. MethodsWe conducted a cross-sectional study among 426 healthy women aged 30 - 60 years who were residents of Dhulikhel and Banepa in central Nepal. We measured cancer stigma using the Cancer Stigma Scale (CASS). CASS measures cancer stigma in six subdomains (awkwardness, avoidance, severity, personal responsibility, policy opposition, financial discrimination) on a 6-point Likert scale (strongly disagree to agree strongly) with higher mean stigma scores correlating with higher levels of stigma. We used univariable and multivariable linear regression to identify the socio-demographic factors associated with the CASS score. ResultsOverall, the level of cancer stigma was low (mean total stigma score: 2.6 {+/-} 0.6) but still present among participants. Stigma related to personal responsibility had the highest levels (mean stigma score: 3.9 {+/-} 1.3), followed by severity (mean stigma score: 3.2 {+/-} 1.3) and financial discrimination (mean stigma score: 2.9 {+/-} 1.6). There was a significant association of mean CASS score with older age (the mean difference is stigma score: 0.01 points; 95% CI: 0.01-0.02) and lower education (difference -0.02 points; 95% CI: -0.03, -0.003) after adjusting for age, ethnicity, education, marital status, religion, occupation, and parity. ConclusionWhile overall cancer stigma was low in Nepal, some subdomains were increased in the general population of women in Nepal. Because stigma may impact engagement in cancer screening efforts, programs should aim to counteract stigma, particularly among older and less educated women.