Determination of the Association between Perceived Stigma and Delay in Help-Seeking Behavior of Women with Breast Cancer

Abstract

Background:One of the leading causes of death in patients with breast cancer is delays in help-seeking, which is influenced by various factors, including social factors such as cancer stigma. Objectives:This study aimed to determine the relationship between perceived stigma and delay in seeking help for women with breast cancer. Methods:In this cross-sectional study, 140 women with breast cancer referred to Besat Clinic in Rasht, Iran, were included. The data gathering tools included a demographic questionnaire, a cancer stigma questionnaire and a delay questionnaire completed through interviews with patients. Data analysis was performed using SPSS software V.21 and the descriptive and inferential statistics were performed using correlation coefficient, chi-square test, logistic regression, Mann-Whitney U-test, and Kruskal-Wallis test. Results:In this study, 72.1% of patients were aged between 39 and 57 years, with a mean age of 47.99±8.03 years; 34.3% and 16.4% of patients delayed seeking help between 30 and 90 days, and more than 90 days (with mean±SD of 75.35±165.19), respectively. Breast cancer stigma was present in 45% of patients. Delay in seeking help based on stigma was significant (P <0.001). Due to multiple logistic regression, the association between stigma and delayed relief was significant (P <0.01), so that in women suffering from breast cancer with stigma, the chance of delaying seeking help was 5.7 times (OR 5/706, Cl 95% 1.381-23.572) higher than women without stigma. Conclusion:Stigma may be a factor in delaying the screening of women with breast cancer. Therefore, it is recommended that the health care team considers stigma as one of the most important psychological aspects of breast cancer, which may have an impact on patients' delay in seeking help. It should also be considered in the process of diagnosis, treatment counseling, and patient follow-up.

TABLE 1.

Perceived stigma and its domains in the studied subjects

TABLE 2.

Comparison of the frequency distribution of delay time in help-seeking of the studied participants since the observation of symptom according to the status of stigma domains.

TABLE 3.

Regression coefficient and relative estimated chance of stigma effects on a delay time exceeding 30 days after balancing the effect of individual socio-individual variables and cancer histories, in the logistic regression model