Multilevel Opportunities to Address Lung Cancer Stigma across the Cancer Control Continuum

Heidi A. Hamann, Elizabeth S. Ver Hoeve, Lisa Carter-Harris, Jamie L. Studts, Jamie S. Ostroff

Research output: Contribution to journalReview articlepeer-review

59 Scopus citations


The public health imperative to reduce the burden of lung cancer has seen unprecedented progress in recent years. Fully realizing the advances in lung cancer treatment and control requires attention to potential barriers in their momentum and implementation. In this analysis, we present and evaluate the argument that stigma is a highly significant barrier to fulfilling the clinical promise of advanced care and reduced lung cancer burden. This evaluation of the stigma of lung cancer is based on a multilevel perspective that incorporates the individual, persons in the individual's immediate environment, the health care system, and the larger societal structure that shapes perceptions and decisions. We also consider current interventions and interventional needs within and across aspects of the lung cancer continuum, including prevention, screening, diagnosis, treatment, and survivorship. Current evidence suggests that stigma detrimentally affects psychosocial, communication, and behavioral outcomes over the entire lung cancer control continuum and across multiple levels. Interventional efforts to alleviate stigma in the context of lung cancer show promise, yet more work is needed to evaluate their impact. Understanding and addressing the multilevel role of stigma is a crucial area for future study to realize the full benefits offered by lung cancer prevention, control, and treatment. Coordinated, interdisciplinary, and well-conceptualized efforts have the potential to reduce the barrier of stigma in the context of lung cancer and facilitate demonstrable improvements in clinical care and quality of life.

Original languageEnglish (US)
Pages (from-to)1062-1075
Number of pages14
JournalJournal of Thoracic Oncology
Issue number8
StatePublished - Aug 2018


  • Cancer control continuum
  • Lung cancer
  • Multilevel approach
  • Stigma

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine


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