Cancer stigma and acceptance: narratives of individuals with cancer and supportive cancer care providers in Kenya

Abstract Background: Cancer stigma complicates the increasing incidence, late diagnosis, high cost of diagnosis and treatment, and high mortality rates that characterize the current state of cancer in Kenya. We sought to understand the sociocultural and psychological factors that contribute to and mitigate cancer stigma and that facilitate or prevent cancer treatment seeking. Methods: This study collaborated with four non-governmental organizations (NGOs) that support cancer survivors in Kenya. Interviews were conducted among 17 individuals with cancer and 16 NGO supportive care providers on sociocultural and psychological factors affecting cancer treatment-seeking behaviors and quality of life. The interviews were transcribed and analyzed thematically. Results: Stigma and acceptance (of cancer as a treatable medical disease) emerged as a major barriers and facilitators, respectively, of patient treatment seeking and quality of life. Cancer stigma seemed to have been influenced by low cancer literacy, cultural/religious beliefs linking cancer with evil and punishment, social ostracism from family and community, lower economic and educational status, and high levels of distress and shame. These factors contributed to delays or avoidance of cancer treatment and poor quality of life. By contrast, cancer acceptance was associated with greater family support, higher cancer literacy, reduced shame and distress, and commitment to seeking and adhering to cancer treatment. Conclusion: Findings support an inverse relationship between cancer stigma and acceptance and illustrate the diverse ways in which they influence cancer treatment seeking, support, and quality of life. Educational and supportive interventions aimed at individual, family, community, and societal levels are needed to increase cancer literacy, reduce stigma, enhance acceptance, and facilitate treatment seeking.