Stigma and Its Association With Social Support and Quality of Life Among Patients With Cervical Cancer in Zambia

Abstract

PURPOSE Zambia is among the countries with the highest cervical cancer incidence and mortality rates globally. Stigma can hinder treatment adherence and overall quality of life for patients with cervical cancer. Research on this topic, however, is lacking in Zambia. This study aimed to assess the levels of stigma among patients with cervical cancer in Zambia and examine the association between social support and quality of life. METHODS We enrolled patients newly diagnosed with cervical cancer at the Cancer Diseases Hospital in Lusaka, Zambia, from July to October 2024. In-person or telephone interviewers collected information on demographic, clinical, and socioeconomic status before treatment. Stigma was assessed using a modified Perceived Stigma Scale, quality of life using the PROMIS-57, and social support with the Multidimensional Scale of Perceived Social Support. Associations between stigma, social support, and quality of life were analyzed using multivariable logistic regression, adjusting for age, education, income, and cancer stage, with significance set at P < .05. RESULTS A total of 213 participants were included in the study with a response rate of 96%. Of the total participants, 30.5% were classified as having high stigma. High levels of support from family (odds ratio [OR], 0.44 [95% CI, 0.22 to 0.87]) and friends (OR, 0.43 [95% CI, 0.21 to 0.91]) reduced the odds of stigma. Severe anxiety, depression, fatigue, sleep disturbances, pain, poor physical function, and low social well-being were all strongly associated with higher stigma (all P ≤ .004). CONCLUSION Perceived cervical cancer–related stigma in Zambia is associated with limited social support and poorer quality of life. Programs to strengthen social network support, as well as targeted mental health treatment, are needed to improve the well-being of patients with cervical cancer in Zambia.