Exploring breast cancer stigma among medical students in Egypt: a national multi-center cross-sectional study.

BACKGROUND

Breast cancer (BC) stigma remains an understudied barrier to early detection and quality care, particularly in low- and middle-income countries (LMICs). Yet, there is a lack of studies that assessed BC stigma among medical students worldwide; a critical gap given their future roles as healthcare providers. This study aims to explore BC stigma among medical students in Egypt and identify its associated factors.

METHODS

A national multi-center cross-sectional study was conducted during the academic Year 2024-2025, involving a convenience sample of 2,576 medical students from eight medical faculties across Egypt's four main regions. Data were collected through an online questionnaire capturing socio-demographic characteristics, educational background, BC-related experiences, and knowledge of BC including students' primary sources of information on the subject, alongside the BC-adapted Cancer Stigma Scale (CASS) that assessed six domains: Severity, Financial Discrimination, Personal Responsibility, Awkwardness, Avoidance, and Policy Opposition. Median (M) scores were computed, and non-parametric tests and multivariate linear regression were used to identify associated factors.

RESULTS

The overall BC stigma score was relatively low, with a median of 2.16 (36% of the total score). However, stigma was highest in Severity and Financial Discrimination (M = 3.0 and 2.67, respectively), and lowest in Avoidance and Policy Opposition (M = 1.00 and 1.33, respectively). Significantly higher stigma scores were observed in males (M = 2.20), those living in Upper Egypt governorates and rural residents (M = 2.30 and 2.24; respectively), and those with less-than-sufficient family income (M = 2.30). The regression analysis revealed significant associations between stigma and various sociodemographic variables, including sex, age, educational year, residence, and family income (p-values < 0.001), and BC-related questions such as history of breast problems and sufficient awareness about BC (both p < 0.001). The primary sources of information about BC for medical students were found to be medical curricula (24.2%), internet/social media (20.0%), and healthcare professionals (16.3%).

CONCLUSION

This study provides an insight into exploring BC stigma among medical students. While the overall stigma was relatively low, significant disparities persist, particularly regarding perceived Severity among male and rural participants. Future interventions should target students with high levels of stigma through curricular reforms that incorporate anti-stigma training.

TRIAL REGISTRATION: Not applicable.