Perceived stigma and depression among colorectal cancer patients

Research Objective: Individuals with a colorectal cancer diagnosis are at elevated risk for depression. Patients' perceptions of stigmatization, devaluation, or blame for their condition may contribute to this risk. This research aims to assess perceptions of stigma, blame, and discrimination among patients with colorectal cancers, and whether these factors contribute to patient depression. Methods: Questionnaires assessing patient characteristics and experiences were mailed to all 2018 living patients diagnosed with stage 1 or higher colorectal cancer in 2008 at any Veterans Affairs facility. Sixty-seven percent (1421) of patients completed the questionnaire, which included validated measures of depression and other health and quality of life outcomes as well as sociodemographic characteristics, perceived discrimination, stigma associated with colorectal cancer, self-blame, and perceptions that others blame the patient for their condition. Associations between stigma experiences and patient depression will be assessed using multivariate regression. Results: There was considerable variation in patient stigma, discrimination, and perceived blame. For example, 12% of patients reported discrimination by health care providers, 26% felt they were at least partially to blame for their illness, and 25% felt there was a stigma that goes with their condition. In preliminary analyses, self-blame, belief that others blame the patient for their illness, perceived discrimination and stigma were all significantly (p<.05) associated with depression. Conclusions: Some individuals with colorectal cancer experience stigma related to their condition, and may blame themselves for acquiring the disease. These occurrences may be important stressors that may contribute to their psychological health and quality of life.