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Negative cancer stereotypes and disease-specific self-concept in head and neck cancer

Authors

  • Janice C. Wong,

    1. Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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  • Ada Y. M. Payne,

    1. Institute of Medical Science, University of Toronto, Toronto, ON, Canada
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  • Kenneth Mah,

    1. Ontario Cancer Institute, Toronto, ON, Canada
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  • Sophie Lebel,

    1. School of Psychology, University of Ottawa, Ottawa, ON, Canada
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  • Ruth N. F. Lee,

    1. Professional Affairs Dept., McMaster University Medical Centre, Hamilton, ON, Canada
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  • Jonathan Irish,

    1. Faculty of Medicine, University of Toronto, Toronto, ON, Canada
    2. Ontario Cancer Institute, Toronto, ON, Canada
    3. Surgical Oncology, Princess Margaret Hospital, Toronto, ON, Canada
    4. Cancer Care Ontario, Toronto, ON, Canada
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  • Gary Rodin,

    1. Faculty of Medicine, University of Toronto, Toronto, ON, Canada
    2. Institute of Medical Science, University of Toronto, Toronto, ON, Canada
    3. Ontario Cancer Institute, Toronto, ON, Canada
    4. Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, Toronto, ON, Canada
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  • Gerald M. Devins

    Corresponding author
    1. Faculty of Medicine, University of Toronto, Toronto, ON, Canada
    2. Institute of Medical Science, University of Toronto, Toronto, ON, Canada
    3. Ontario Cancer Institute, Toronto, ON, Canada
    4. Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, Toronto, ON, Canada
    • Cancer Care Ontario, Toronto, ON, Canada
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Correspondence to: Ontario Cancer Institute, 200 Elizabeth Street 9EN-223, Toronto, ON, M5G 2C4 Canada. E-mail: gdevins@uhnres.utoronto.ca

Abstract

Background

Life-threatening diseases, such as head and neck cancer (HNCa), can stimulate the emergence of a new disease-specific self-concept. We hypothesized that (i) negative cancer-stereotypes invoke distancing, which inhibits the adoption of a disease-specific self-concept and (ii) patient characteristics, disease and treatment factors, and cancer-related stressors moderate the phenomenon.

Methods

Head and neck cancer outpatients (N = 522) completed a semantic-differential measure of disease-specific self-concept (perceived similarity to the ‘cancer patient’) and other self-report measures in structured interviews. Negative cancer-stereotypes were represented by the number of semantic-differential dimensions (0–3) along which respondents evaluated the stereotypic ‘cancer patient’ negatively (i.e., negative valence). We tested the two-way interactions between negative valence and hypothesized moderator variables.

Results

We observed significant negative valence × moderator interactions for the following: (i) patient characteristics (education, employment, social networks); (ii) disease and treatment factors (cancer-symptom burden); and (iii) cancer-related stressors (uncertainty, lack of information, and existential threats). Negative cancer stereotypes were consistently associated with distancing of self from the stereotypic ‘cancer patient,’ but the effect varied across moderator variables. All significant moderators (except employment and social networks) were associated with increasing perceived similarity to the ‘cancer patient’ when respondents maintained negative stereotypes; perceived similarity decreased when people were employed or had extensive social networks. Moderator effects were less pronounced when respondents did not endorse negative cancer stereotypes.

Discussion

When they hold negative stereotypes, people with HNCa distance themselves from a ‘cancer patient’ identity to preserve self-esteem or social status, but exposure to cancer-related stressors and adaptive demands may attenuate these effects. Copyright © 2012 John Wiley & Sons, Ltd.

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