Stigma may be an important barrier to patients with lung cancer becoming involved in advocacy. These findings were published in Oncology Nursing Forum.

Lung cancer is the second most common cancer in the United States; however, visibility and lung cancer-associated funding lags behind other cancers. Barriers to becoming involved with lung cancer advocacy include the high mortality rate, high symptom burden, and perceived stigma.

To evaluate the effect of stigma on advocacy, 266 patients with lung cancer were invited to complete a survey at 2 National Cancer Institute-designated comprehensive cancer centers.

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Participating patients were mean age 63.3 years, 64% were women, 80% were non-Hispanic White, 23% had no smoking history, 55% had stage IV disease, 89% had non-small cell lung cancer, and 65% were currently undergoing treatment.

Higher advocacy scores were observed among patients with stage III or IV disease (t, 2.54; P =.01) and those receiving treatment (t, 2.45; P =.015), and lower scores were observed among current tobacco users (t, 2.83; P =.006). Advocacy scores were not related to gender, ethnicity, education, marital status, or type of lung cancer.

Being involved with an advocacy group was positively correlated with perceived stigma and Lung Cancer Stigma Inventory (LCSI) score, wanting to help others with lung cancer was positively correlated with LCSI score and negatively correlated with constrained disclosure, and trying to share experiences with others was negatively correlated with constrained disclosure (all P <.05).

In the full model, negative predictors for advocacy involvement included age (b, -0.05; P =.003) and constrained disclosure (b, -0.13; P =.003).

This study may have been limited by concentrating on only three aspects of advocacy.

These data indicated that reluctance or discomfort with disclosing lung cancer status may be a barrier to patient advocacy. Additional research is needed to better understand the role of stigma in lung cancer.


Price SN, Shen M, Rigney M, Ostroff JS, Hamann HA. Identifying barriers to advocacy among patients with lung cancer: the role of stigma-related interpersonal constraint. Oncol Nurs Forum. 2022;49(6):553-563. doi:10.1188/22.ONF.553-563

This article originally appeared on Oncology Nurse Advisor