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. 2019 Mar;11(Suppl 4):S596–S611. doi: 10.21037/jtd.2019.01.63

Table 7. Prospective, observational studies investigating stigma as a mechanism perpetuating surgical disparities.

Source Data source # of lung cancer patients Years studied Research question Finding
Carter-Harris (73) Institutional 93 2012–2013 What is the impact of perceived stigma on the timing of medical help-seeking behavior among lung cancer patients? Self-reported stigma was associated with the desire to delay seeking medical care among lung cancer patients
Criswell et al. (74) Multi-institutional 213 To what extent to lung cancer patients feel stigma, regret, and personal responsibility for their disease? Feelings of personal responsibility were greatest among ever smokers. For never smokers, feelings of regret and stigmatization were associated with greatest adverse psychological outcomes
Ernst et al. (75) German Cancer Registries 125 2016 What is the impact of stigmatization on patient reported quality of life among those with cancers of the breast, colon, lung, and prostate? Lung cancer patients self-report high levels of perceived isolation and had higher levels of internalized shame compared to patients with other types of cancer. Stigmatization was found to be inversely correlated with quality of life
LoConte et al. (76) Multi-institutional 327 2006 Do levels of guilt, shame, depression, and anxiety differ in patients with lung cancer compared to those with breast or prostate cancer? Lung cancer patients had greater perceived cancer related stigma. Overall there was no difference in levels of guilt or shame across cancer groups, however, a history of smoking did correlate with generalized guilt and shame
Wassenaar et al. (77) Community practice 672 2005 Do primary care providers differ in treatment and referral patterns for breast cancer patients compared to lung cancer patients? Primary care physicians were less likely to refer advanced lung cancer patients for additional care than advanced breast cancer patients. Physicians were also less likely to understand the benefits of chemotherapy for advanced lung cancer than advanced breast cancer
Weiss et al. (78) Lung Cancer Alliance 174 2008 What factors are associated with lung cancer patient feelings of stigmatization and self-blame? Smoking status was associated with feelings of self-blame and stigmatization, as well as perceived differences in treatment by healthcare professionals
Williamson et al. (79) Institutional 101 Do feelings of internalized stigma impact physical, emotional, and functional quality of life outcomes in lung cancer patients? Ever smokers reported higher rates of internalized stigma than never smokers. Higher internalized stigma was associated with poorer emotional, physical, and functional quality of life