“Exploring Cancer-Related Stigma in Sub-Saharan Africa (ECASSA)” was selected for funding for the interdisciplinary research collaboration pilot grant at the Duke Global Health Institute (DGHI). The PI of the study is Nosa Osazuwa-Peters from the Department of Head and Neck Surgery & Communication Sciences, and Brandon Knettel, assistant professor, will serve as Co-PI.

Abstract

Cancer is highly stigmatized in Africa, including in the East African nation of Tanzania. Cancer incidence has increased dramatically in the region in recent decades, and the lack of treatment options in many African settings leads to conceptualization of a cancer diagnosis as a death sentence. Cancer-related stigma is an urgent public health imperative. It is multidimensional and pervasive, impacting patients throughout the cancer continuum, including prevention, early detection, access and adherence to care, survivorship, and quality of life. However, research on the subject has been limited, and the nature and full extent of cancer-related stigma in Tanzania is unclear. Leveraging expertise in cancer-related mental health outcomes, and our previous work in HIV/AIDS stigma in the region, our long-term goal is to develop a stigma reduction intervention that reduces the harmful effects of stigma among cancer patients and their families in Africa. In this pilot study, we aim to gather strong data on the social and cultural determinants of cancer stigma and resulting delays in seeking cancer care using a previously validated tool, the Cataldo Lung Cancer Stigma Scale (CLCSS). We will examine predictors of self-perceived cancer stigma in a cross-sectional cohort of 150 cancer patients in Tanzania using an adapted CLCSS. We will also determine associations between self-perceived stigma and timing of care-seeking. Results of this project will form the basis for future NIH grant submissions to develop interventions addressing psychosocial drivers of cancer-related stigma and associated care delays.