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Eleni Rapsomaniki

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    MA22 - Partnering with Patients to Understand Stigma, Disparities and Values Leading to Improved Lung Cancer Care (ID 154)

    • Event: WCLC 2019
    • Type: Mini Oral Session
    • Track: Advocacy
    • Presentations: 1
    • Now Available
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      MA22.10 - The Role of Stigma in Differential Care for Lung Cancer Patients: A Decade of Patient and Oncologist Attitudes (Now Available) (ID 2540)

      15:45 - 17:15  |  Author(s): Eleni Rapsomaniki

      • Abstract
      • Presentation
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      The presence of lung cancer stigma is well documented (Chapple et al, 2004; Chambers et al, 2012; Marlow et al, 2015) and has been shown to impact the care and treatment of lung cancer survivors (Tod et al. 2008; Carter-Harris et al 2014). In 2008, a large survey of over 200 patients, 200 oncologists, and 1000 members of the general population revealed that most participants felt that lung cancer was principally caused by external factors, that it was preventable, and that lung cancer patients were at least partly to blame for their illness (Weiss et al. 2014; Weiss et al. 2017). The last decade has brought significant changes in the treatment paradigm for lung cancer but it was unknown if the perceptions that affect the care of lung cancer patients have changed.


      1001 members of the general public, 208 patients with lung cancer, and 205 oncologists who treat lung cancer were surveyed with the identical survey instrument from 2008 survey along with 5-15 additional questions at the end. The survey was carried out by phone and online between June 6 and July 26, 2018. Statistical analysis was performed comparing 2008 and 2018 datasets using paired t-tests if normally distributed or Mann-Whitney U tests for continuous data and Chi-squared or Fisher’s exact test for categorical data.


      In 2018, significantly more oncologists feel they have adequate treatment options for metastatic lung cancer (67% vs 36%, p<.001) and the majority of patients report being satisfied with their medical care (87%) and treatment options (71%).

      Nevertheless, significantly more patients felt that there was a stigma associated with having lung cancer (70% vs. 54%, p<.0001) and that society treats them differently (63% vs 45%, p<.0001). There was a non-significant increase in oncologists indicating that there is a stigma associated with lung cancer (68% in 2018 vs 60% in 2008) and that patients blame themselves (67% vs 57%).

      Despite the improvements in lung cancer treatment over the past decade, stigma is still evident in care for those with lung cancer. Similar to 2008, 57% of oncologists indicated that patients with different types of cancer were thought about, approached, or handled differently and lung cancer patients were most frequently cited. In 2018, more patients reported that patients with lung cancer are treated differently by doctors and nurses (40% vs. 26%, p=.01). For both groups, the most common differential treatment referenced was “received less sympathy from medical staff.”


      After a decade of research progress in lung cancer, stigma surrounding the disease remains a critical problem even in a healthcare setting. Patients are perceiving stigma at higher levels and oncologists are not reporting any improvement. This work underscores the need to address stigma with proactive multilevel approaches including the need for medical providers to practice empathic communication.

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