Brief Report: Ten Year Cross-sectional Analysis of Public, Oncologist, and Patient Attitudes About Lung Cancer and Associated Stigma

INTRODUCTION Lung cancer stigma negatively impacts the clinical care and outcomes of those diagnosed resulting in enduring disparities. The objective was to determine whether attitudes about lung cancer and stigmatization of people diagnosed changed over a decade. METHODS A cross-sectional survey was administered to the general public, oncologists, and people with lung cancer ten years apart (2008 and 2018) using the same instrument and methodology. Measures of stigma agreement ratings on a 5 point Likert scale were compared between 2008 and 2018 for all three sample groups. RESULTS In 2018, 1001 members of the general public, 205 oncologists, and 208 people with lung cancer were enrolled. Improvements were noted over the decade, including the availability of more treatment options. Greater disease awareness was also found, with 94% of the public reporting knowledge of lung cancer (vs 82.5% in 2008, p<.0001) However, no significant change was found in the percentage of the public reporting that lung cancer patients are at least partially to blame for their illness (60.3% in 2018). More people with lung cancer agreed there is a stigma associated with lung cancer in 2018 and (72.1 vs 54.5%, p<.001) and that those diagnosed are viewed or treated differently by society in general (69.4% vs 50.8%, p<.001). CONCLUSIONS The results reflect recognition of treatment gains and increased visibility of lung cancer but also highlight that stigma remains a significant problem. Of critical importance to the care of those diagnosed was the unexpected increase in stigma reported by the patient population.