Oluwaseyifunmi Andi Agbejule, Fiona Crawford-Williams, Ria Joseph, Kim Hobbs, Carla Thamm, Sue Woodall, Ashleigh R Sharman, Joe Wing Pun, Monique Bareham, Jenny Richards, James Scheibner, Catherine Paterson, Raymond J Chan
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引用次数: 0
Abstract
Objective: This scoping review examines the available qualitative evidence from systematic and scoping reviews, and mixed-methods or qualitative studies on cancer-related discrimination.
Methods: Cancer-related discrimination was defined as direct and recurring experiences of enacted stigma, behaviours, or unfair treatment based on an individual's cancer history, current cancer diagnosis, perceived cancer risk, or cancer caregiving role. A systematic search of ProQuest databases, Cochrane CENTRAL, Scopus, APA PsycINFO, MEDLINE, and Web of Science identified peer-reviewed research published before December 13, 2025. Two independent reviewers screened studies, and data were narratively synthesised using the Health Stigma and Discrimination Framework (i.e., drivers and system-level facilitators; discrimination experiences; impacts).
Results: In total, 116 studies met inclusion criteria, comprising 83 qualitative studies, 23 mixed-method, nine systematic reviews, and one scoping review. Cancer-related discrimination was reported across four contexts: (1) familial and social; (2) hiring and workplace; (3) insurance and welfare; and (4) healthcare. Discrimination drivers included misconceptions that cancer is contagious, employer concerns about productivity and costs, rigid welfare regulations, and reduced public empathy for cancers perceived as 'self-inflicted'. Reported experiences ranged from social exclusion and bullying, to workplace dismissals, job rejections, and barriers to insurance or financial support. In healthcare contexts, provider blame, judgement, and strained patient-clinician interactions were reported. Impacts of discrimination included self-isolation, concealment of diagnosis, internalised stigma, psychological distress, financial burden, and delayed treatment-seeking.
Conclusions: Cancer-related discrimination arises from cultural, institutional, and structural mechanisms, with significant impacts on quality of life and health. Coordinated policy, legal, institutional, and public education responses are required to address these challenges.
目的：本综述从系统综述和范围综述，以及混合方法或癌症相关歧视定性研究中检查现有的定性证据。方法：癌症相关歧视被定义为基于个人癌症病史、当前癌症诊断、感知癌症风险或癌症护理角色的直接和反复经历的制定的耻辱、行为或不公平待遇。通过对ProQuest数据库、Cochrane CENTRAL、Scopus、APA PsycINFO、MEDLINE和Web of Science的系统搜索，确定了2025年12月13日之前发表的同行评议研究。两名独立审稿人筛选了研究，并使用健康耻辱和歧视框架（即驱动因素和系统级促进因素；歧视经验；影响）对数据进行了叙述性综合。结果：总共有116项研究符合纳入标准，包括83项定性研究、23项混合方法研究、9项系统评价和1项范围评价。癌症相关的歧视有四种情况：(1)家庭和社会；（二）用人和工作场所；（三）保险和福利；(4)医疗保健。造成歧视的因素包括对癌症具有传染性的误解、雇主对生产率和成本的担忧、严格的福利规定，以及公众对被认为是“自己造成的”癌症的同情减少。报告的经历包括社会排斥和欺凌，工作场所解雇，工作拒绝以及获得保险或经济支持的障碍。在医疗环境中，提供者的指责，判断和紧张的医患互动被报道。歧视的影响包括自我隔离、隐瞒诊断、内化耻辱、心理困扰、经济负担和延迟寻求治疗。结论：癌症相关歧视源于文化、体制和结构机制，对生活质量和健康有显著影响。应对这些挑战需要协调一致的政策、法律、制度和公共教育对策。
期刊介绍：
Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology.
This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues.
Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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