Perceived stigmatization in cancer patients during the first year after diagnosis: the role of socioeconomic status.

Purpose: Stigmatization in cancer patients leads to poorer health-related outcomes. The effect of socioeconomic status (SES) on stigmatization has not been investigated. We therefore aim to investigate, which differences in stigmatization in cancer patients regarding SES exist up to one year after diagnosis and which medical and demographic characteristics are associated with stigmatization.

Methods: Patients with different solid cancer diagnoses were assessed within two months after diagnosis (t1) and at a 12-month follow-up (t2). Stigmatization was assessed using the Social Impact Scale (SIS), which comprises four dimensions: isolation, rejection, shame and financial insecurity. An SIS-total score can be computed. Bivariate and multiple regression analysis were performed.

Results: Six hundred-eighty patients completed the assessments (mean age 60.4; 51.2% male; most prevalent cancers: prostate (21.0%), skin (17.1%), breast (16.2%)). Stigmatization at t1 was moderate in all dimensions, independent of SES. It decreased at t2, especially in patients with middle or high SES (p < 0.001). Low SES was identified as a risk factor for stigmatization at t2 (p = 0.036 - p < 0.001). Other predictors include stigmatization at t1 as well as distress, disease stage and cancer diagnosis, e.g. lung cancer. The predictors explained 27-43% of the variance in stigmatization in the four dimensions resp. in the SIS-total score.

Conclusion: Stigmatization after cancer diagnosis was dependent of SES. Reasons may be fewer social and economic resources, lower health literacy and insufficient consideration of the specific needs of this patient group in the healthcare system.

Implication for cancer survivors: Patients with low SES should receive greater attention in the medical care system and in scientific research to identify and mitigate possible burdens and subsequent problems.