University of Mannheim: Stigmatization of lung cancer makes therapy innovations difficult

“Lung cancer carries a specific social stigma because it is associated with cigarette consumption. It is often viewed as a smoking disease that is self-inflicted and preventable, ”write professors Laura Grigolon from the University of Mannheim and Laura Lasio from McGill University in Montreal.

According to a 2010 study by the Global Lung Cancer Coalition in Canada, 22 percent of respondents admitted that they feel less sympathy for lung cancer patients than for patients with other tumors.

Compared with patients who are affected by other types of cancer with similar chances of survival, lung cancer patients are treated much less often, report Grigolon and Lasio in their study. The treatment rate for lung cancer patients is around 25 percent, while it is around 60 percent for colon cancer. Although lung cancer is responsible for 32 percent of cancer deaths in the United States, only 10 percent of research funds are used on this cancer, it says with reference to further studies.

To assess the impact of the stigma of lung cancer, the researchers analyzed administrative data from patients with advanced disease in the Canadian province of Ontario over a period of ten years. To do this, they used detailed geographic data to map the stigmatization in a model of the patient benefit of a treatment.

Stigma is defined as an endogenous social effect and is measured by the proportion of patients in the neighborhood who were diagnosed in the previous year and received no treatment. Even if socio-demographic factors such as income, age and state of health play a key role in participation in treatment, social stigma is a “substantial” obstacle to therapy.

While colon cancer is comparable to lung cancer in terms of the consequences of neglecting treatment, stigmatization of the disease does not play a role here, the researchers found.

“All in all, the results provide convincing evidence that fewer patients are being treated because of the stigma, which in turn slows the spread of innovative treatments and creates fewer incentives for investment in research and development,” say Grigolon and Lasio.

Conversely, eliminating the stigma would increase the treatment rate and lead to 4 percent more innovative therapies, whereby the effort for better chances of survival would be lower than the additional costs for the treatment, it said. Therefore, the issue of stigma should be considered by decision-makers when designing interventions aimed at improving access to treatment.

More information about the study

Laura Grigolon is a member of the Collaborative Research Center Transregio 224 EPoS. The discussion paper presented is a publication by EPoS. Please click here for the full study. A list of all discussion papers can be found here .

The Collaborative Research Center Transregio 224 EPoS, established in 2018 and a cooperation between the University of Bonn and the University of Mannheim, is a long-term research institution funded by the German Research Foundation (DFG). EPoS deals with three central societal challenges: How can equal opportunities be promoted? How can markets be regulated in view of the internationalization and digitization of economic activity? And how can the stability of the financial system be ensured?

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