The impact of stigma on patient delay in colorectal cancer: A qualitative study from the perspectives of patients and family members.

PURPOSE: To explore the impact of stigma on the patient delay for colorectal cancer from the perspectives of patients and their family members.

METHODS

A descriptive phenomenological design was conducted. In total, 30 patients and 17 family members of patients were recruited from a Grade-A tertiary cancer center in southern China through purposive sampling. In-depth interviews were conducted using a semi-structured guide. The data were organized by NVivo 11 and qualitatively analyzed using thematic analysis.

RESULTS

Four themes and twelve subthemes were generated from the interviews: (1) cancer stereotypes (a proxy for death and cultural taboos); (2) symptom attribution (rationalization and benignization, denying the possibility of cancer and evasion of suspected cancer); (3) barriers to symptom disclosure (concealment of symptoms, negative effects of symptom disclosure and weakened description of symptoms); (4) resistance to seeking medical attention (negative symbolism of the hospital, embarrassment and pain during diagnosis and treatment, fear of cancer diagnosis, and internalized ageism of the elderly).

CONCLUSIONS

Stigma plays a crucial role in patient delay of colorectal cancer in China. To reduce delays, interventions should address cultural stereotypes, encourage early identification of symptoms, promote symptom disclosure, and reduce psychological barriers to seeking medical attention. Culturally sensitive strategies are essential in tackling the stigma that impedes timely cancer treatment.