Breaking Barriers: Unveiling Cancer Stigma among Healthy Population in Western Mahatrashtra- A Cross sectional Study

Abstract Background Significance: Cancer stigma in India continues to be a major barrier for both patients and their families, largely driven by inadequate awareness, limited health literacy, and persistent cultural misconceptions. Such stigma leads to fear, delayed health-seeking, reduced adherence to treatment, and emotional distress. It also places substantial social, psychological, and economic burdens on caregivers, who may experience isolation, discrimination, and heightened anxiety. Understanding stigma levels among healthy individuals is essential, as they represent the future caregivers and potential patients who will shape community attitudes. This study aims to assess the level and pattern of cancer-related stigma among the healthy population in Western Maharashtra. Materials and Methods: A cross-sectional study was conducted among 267 healthy individuals visiting a tertiary care hospital in Western Maharashtra, India, from March 2023 to August 2023. Participants aged 18 years and above who had no prior diagnosis of cancer were included using a convenient sampling method. Data were collected through a structured, self-administered questionnaire incorporating the validated Cancer Stigma Scale (CASS), which assesses six subdomains: Awkwardness, Severity, Avoidance, Policy Opposition, Personal Responsibility, and Financial Discrimination. Each item was scored on a Likert scale, and subdomain scores were calculated accordingly. The questionnaire also included sociodemographic details such as age, gender, education, occupation, and socioeconomic status. Data entry was performed in Microsoft Excel and analysis was carried out using SPSS version 26. Descriptive statistics including median, mean, and standard deviation were computed. Inferential analysis using the Mann–Whitney U test was performed to assess associations between stigma levels and demographic variables, with statistical significance set at P < 0.05. Results: Levels of cancer stigma were moderate but varied across the six subdomains in our study. The attitudes of respondents were reflected through their agreement with various statements, where 35% of people agreed on “Cancer patient being liable and accountable for their condition,” approximately15% believed that “Once you’ve had cancer you’re never normal again,” while 9% of respondents felt that “Cancer devastates the life of those it touches.” Furthermore, 45% of healthy individuals expressed that “It is not acceptable to refuse the bank loan for the cancer patient.” About 43% people strongly agree on “policy opposition,” i.e. “More government funding should be spent on care and treatment of those with cancer.” People strongly disagree on any kind of awkwardness or avoidance related to cancer patients. Significant differences in policy opposition are observed among participants with distinct employment status ( P < 0.05). Conclusions: The study indicates the enduring presence of cancer stigma among the healthy population in Western Maharashtra, with the observed highest stigma related to the severity of the disease and policy opposition. Findings provide a critical baseline for designing targeted educational and stigma-reduction interventions, particularly for communities expected to serve as caregivers in the future.