Abstract

Background

Qualitative research with ethnic minority groups often finds that participants feel cancer is stigmatised or ‘taboo’. Cancer stigma has also been shown to influence engagement with cancer prevention/early detection behaviours particularly in some ethnic minority groups.  To date there have been few studies attempting to quantify perceptions of stigma in ethnic minority populations. We aimed to explore differences in cancer stigma in a sample of ethnic minority women and the association between cancer stigma and attendance at cervical screening.    

Method

Women aged 30-60 years were recruited from Indian, Pakistani, Bangladeshi, Caribbean, African and white British backgrounds (n=720, response rate = 65%).  Participants completed face-to-face interviews with a multi-lingual interviewer.  We assessed socio-demographics, self-reported cervical screening attendance, and four dimensions of cancer stigma: personal responsibility, awkwardness, avoidance and community-level stigma.  

Results

There were significant differences by ethnic group for each of the four stigma dimensions (p<.001 for each), with White British women scoring lowest on each.  Differences on individual items were striking, for example <5% of Bangladeshi and Pakistani women believed cancer was talked about openly in their community compared to 97% of White British women.  Across all ethnic groups, personal responsibility, awkwardness and avoidance scores were significantly lower among those born in the UK, but there were no differences in community stigma. Cancer stigma was significantly associated with increased odds of non-attendance for cervical screening.  This was the case for community stigma (OR=1.09), personal responsibility (OR=1.12), awkwardness (OR=1.12) and avoidance (OR=1.15).  Odds ratios were small but highly significant (p<.001).

Conclusion

While low in the general population, cancer stigma is prevalent in ethnic minority groups, even among the younger generation, and is associated with cervical screening status. Interventions to tackle stigma in ethnic minority populations could be a first step to addressing ethnic inequalities in cancer awareness and preventive behaviours.