Patient Perspectives on Impact of Weight and Weight Stigma on Breast and Cervical Cancer Treatment: A Qualitative Study

IF 3.1 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2025-03-20 DOI:10.1002/cam4.70823

Jamie L. Sorensen, Michele M. West, Kathleen M. Robinson, Mary E. Charlton, Ingrid M. Lizarraga, Sarah H. Nash

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Abstract

Background

Higher weight individuals report experiencing weight-based stigma in the healthcare setting; within the cancer continuum, the most robust evidence exists for cancer screening. More research is needed to understand whether and how higher weight patients experience weight stigma during cancer treatment.

Methods

We conducted semi-structured interviews with 15 breast and 15 cervical cancer survivors diagnosed 2017–2019 in Iowa who had a pre-diagnosis body mass index of 30+ kg/m² calculated from their driver's license height and weight. Interviews focused on whether individuals perceived being treated differently because of their weight in daily life, in healthcare, or during cancer treatment. Data were coded using a combination of inductive and deductive approaches, and analyzed using a multi-phase thematic analysis.

Results

Almost all interviewees reported positive experiences during cancer treatment; several described their weight as never being an issue. Some identified weight stigma during cancer diagnosis or treatment that resulted in delayed diagnoses or changes in treatment. Many interviewees described situations where their weight was discussed negatively during cancer treatment, but most did not identify these as stigmatizing because their providers were only “concerned about [their] health.” Additional themes developed included experiencing environmental stigma, the discussion of cancer recurrence by providers only as it related to weight, and misconceptions of the causes and consequences of obesity.

Conclusions

While several participants did not feel that their weight impacted cancer treatment, some reported experiences of weight stigma pre-diagnosis and during treatment. When individuals noted their weight was discussed during treatment, internalized bias may have impacted whether they considered these discussions stigmatizing.

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患者对体重和体重耻辱感对乳腺癌和宫颈癌治疗影响的看法：一项定性研究。

背景：高体重个体报告在医疗保健环境中经历基于体重的耻辱感；在癌症连续体中，最有力的证据存在于癌症筛查。需要更多的研究来了解体重较高的患者在癌症治疗期间是否以及如何经历体重耻辱。方法：我们对爱荷华州诊断为2017-2019年的15名乳腺癌和15名宫颈癌幸存者进行了半结构化访谈，他们的诊断前体重指数为30+ kg/m2，根据其驾驶执照的身高和体重计算。访谈的重点是人们是否认为在日常生活、医疗保健或癌症治疗过程中因体重而受到不同对待。采用归纳和演绎相结合的方法对数据进行编码，并使用多阶段主题分析进行分析。结果：几乎所有受访者都报告了癌症治疗期间的积极经历；一些人说他们的体重从来都不是问题。一些人在癌症诊断或治疗期间发现了体重耻辱感，导致诊断延迟或治疗改变。许多受访者描述了在癌症治疗期间他们的体重被消极地讨论的情况，但大多数人并不认为这是一种耻辱，因为他们的提供者只是“关心[他们的]健康”。发展的其他主题包括经历环境污名，提供者只讨论与体重有关的癌症复发，以及对肥胖的原因和后果的误解。结论：虽然一些参与者不认为他们的体重影响癌症治疗，但一些人报告了在诊断前和治疗期间体重耻辱的经历。当个体注意到他们的体重在治疗期间被讨论时，内化偏见可能会影响他们是否认为这些讨论是耻辱。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.