“Lung cancer carries a unique social stigma due to its association with cigarette smoking, and hence is
often seen as a smoker’s disease, self-inflicted, and preventable,” researchers at the University of
Mannheim and the McGill University in Montreal wrote in the paper.
In Canada, 22 percent of the population admitted to have less sympathy for a person with lung cancer
than people with other tumours, a 2010 survey by the Global Lung Cancer Coalition stated.
Compared with patients affected by cancers with similar survival chances, lung cancer patients accessed
treatment to a significantly lesser extent, authors Laura Grigolon and Laura Lasio said.
Treatment rates are around 25 percent for metastatic lung cancer, but reach 60 percent for colorectal
cancer patients. Moreover, while lung cancer is responsible for 32 percent of cancer deaths in the
US, it receives only 10 percent of cancer research funding, other research showed.
To assess the repercussions of social stigma, the study used administrative data on the population of
patients diagnosed with advanced lung cancer in Ontario, Canada, over the last decade. It exploited
the unique level of geographic detail to incorporate social stigma in a model of patient’s utility from
pursuing treatment.
Stigma is defined as a form of endogenous social effect and measured as the share of patients in the
neighbourhood who were diagnosed in the past and did not receive treatment.
While patient’s socio-demographic characteristics such as income, age and health status play a key
role in treatment participation, social stigma is an additional “substantial” barrier to access treatment,
the authors said.
The authors find no role for social stigma on treatment participation for colorectal cancer patients,
which is similar to lung cancer in terms of treatment and prognosis when left untreated, but does not
carry the same stigma.
“All in all, the results provide strong evidence that the patients face accessibility problems linked to
stigma, which in turn slows down the adoption of innovative treatments and are likely to lower the
incentives to invest in research and development.”
Conversely, removing social stigma would increase treatment rates and result in a four percent increase
in the use of innovative therapies, with benefits in survival outweighing the additional treatment
costs, according to the paper.
Hence, social stigma “should be taken into account by policy makers when designing policies to mitigate
disparities in access to care,” Grigolon and Lasio argue.
Laura Grigolon is member of the Collaborative Research Center Transregio 224 EPoS. The presented discussion
paper is a publication without peer review of the Collaborative Research Center Transregio 224 EPoS.