The dual burden of stigma: a scoping review of its impact on colorectal cancer patients and screening participants

BMC Public Health. 2025 Oct 8;25(1):3377. doi: 10.1186/s12889-025-24782-x.

ABSTRACT

BACKGROUND: The stigma caused by colorectal cancer (CRC) and CRC screening affects CRC prevention and treatment. Based on the Health Stigma and Discrimination Framework (HSDF), this review analyzed the influencing factors and mechanism of stigma in CRC.

METHODS: We conducted a scoping review in accordance with the PRISMA-ScR guidelines and searched PubMed, Web of Science, Scopus, and CNKI. The RoBANS tool was used for quantitative studies, and the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research tool was used for qualitative studies. Data were integrated on the basis of the HSDF.

RESULTS: Among the 15 included studies, 10 focused on CRC patients, and 5 focused on screening participants. These studies covered driving factors (14 studies), facilitating factors (11 studies), stigma “marking” (13 studies), individual experiences (12 studies), and social practices (13 studies). Additionally, a total of 3150 participants were included in the studies, comprising 2876 patients and 274 screening participants. Studies have shown that the factors influencing CRC-related stigma differ across different groups. CRC patients experience disease-related stigma and survival-related stigma, such as ostomy discrimination and employment discrimination. The screening of participants involves invasive examinations and asymptomatic population screening. The above stigmatization may lead to negative consequences such as deterioration in quality of life, decreased treatment compliance, delayed screening, and psychological distress (anxiety, depression). This study revealed that CRC-related stigma may be influenced by age, gender, religion, culture and the economy. Through improving social support and health policy, the negative effects of stigmatization can be gradually eliminated.

CONCLUSION: CRC-related stigma has measurable impacts on patient well-being and care-seeking. Although some studies suggest potential strategies to reduce stigma, further research is needed to evaluate effective interventions and their role in promoting screening participation.

PMID:41063126 | DOI:10.1186/s12889-025-24782-x