Cultural influences on stigma and coping in Oral cancer patients: a cross-cultural perspective

Cultural beliefs shape how oral cancer patients perceive their illness, seek support, and manage psychological distress, particularly amid tobacco-related stigma. This study examines the role of cultural context in stigma, help-seeking behaviors, and mental health outcomes in oral squamous cell carcinoma (OSCC) patients, comparing rural and urban subcultures in India and referencing global literature.

We conducted a prospective study at H.P. Government Dental College and Hospital, Shimla, enrolling 56 OSCC patients from rural and urban backgrounds. We assessed psychological burden and quality of life using the Depression, Anxiety, and Stress Scale (DASS-21) and EORTC QLQ-H&N43 at diagnosis, two weeks, one month, and six months post-treatment. We analyzed data to identify correlations between stigma, subcultural context, mental health, and help-seeking behavior.

Rural patients reported significantly higher stigma and delayed help-seeking, associated with increased depression and stress over time. Urban patients exhibited proactive coping and better quality of life, despite similar tobacco-related stigma. Cross-cultural comparisons indicate that shame and stigma in tobacco-prevalent societies delay care and worsen psychological morbidity.

Stigma rooted in cultural beliefs hinders timely diagnosis and psychological resilience in OSCC patients, especially in rural settings. Culturally sensitive psycho-oncology frameworks are needed to address stigma, promote mental health, and enhance help-seeking to improve oncologic and psychosocial outcomes.