Metaphors and Stigma in Confucian Culture: A Qualitative Study of Cancer Risk Communication Dilemmas for Cascade Screening Among Hereditary Cancer Families From China.

Abstract

Objective: The rate of cascade screening in China is very low, and little attention has been given to the communication of cancer risk. It is important to explore Confucian perspectives to identify cancer risk communication dilemmas for cascade screening among hereditary cancer families in China. This study aimed to gain insight into the processes and barriers of cancer risk communication for cascade screening among hereditary cancer families from the perspective of probands with hereditary cancer within the special Confucian cultural context of China.

Methods: Semi-structured interviews were conducted with 31 probands with hereditary cancer. Thematic analysis was conducted by two researchers. The Consolidated Criteria for Reporting Qualitative Research was used to guide this article.

Results: Three major themes related to the processes and dilemmas in cancer risk communication for cascade screening among hereditary cancer families from China emerged: Confucian metaphors framing hereditary cancer as moral condemnation; Social stigma amplifying collective silence; Hereditary cancer means family doom due to poor communication about cancer risk.

Conclusions: The findings of this study highlight the urgent need to integrate cultural factors into cancer risk communication and cascade screening strategies for hereditary cancer families in Confucian cultural contexts. By understanding and addressing the impact of Confucian metaphors and social stigma, it is possible to develop more culturally appropriate and effective communication models, which can improve the participation rate of cascade screening, reduce the psychological burden of families, and ultimately improve the prevention and treatment outcomes of hereditary cancer.