Pilot Study Assessing Stigma in Kenyan Women With Breast Cancer

Breast cancer is the most common female cancer in Kenya, frequently presenting at late stage, and associated with high mortality. The stigma around cancer has been identified as a barrier to early detection and treatment in many settings globally. This pilot study investigated associations between breast cancer stigma, depression, anxiety, and health-related quality of life (HRQOL) outcomes.

A cross-sectional survey of 60 participants (30 newly diagnosed breast cancer [NDBC] and 30 previously treated breast cancer [PTBC]) was conducted at Aga Khan University Hospital, Nairobi, Kenya. Validated survey measures included a chronic illness stigma scale adapted for breast cancer, depression, anxiety, and HRQOL. Penalized logistic and linear regression analyses were also performed.

The participants' mean age was 49.9 years (±12.1). A quarter (25%) of the participants experienced anxiety, whereas 13.3% showed signs of depression, with a mean HRQOL score of 79 (±16.9). The mean breast cancer stigma score was 39.8 (±14.9). The adjusted predicted probability of depression increased as the stigma score increased and was higher among PTBC participants than NDBC participants. The adjusted predicted probability of anxiety also increased as the stigma scores increased and was higher among those who had NDBC than PTBC participants. The adjusted predicted change in the log of HRQOL decreased as the stigma score increased and was higher among NDBC participants than PTBC participants at diagnosis.

Among women diagnosed with breast cancer, this study highlights the association of increased breast cancer-related stigma with anxiety, depression, and lower QOL.