Stigma-Related Experiences and Their Associations With Sociodemographic and Clinical Characteristics Among Breast Cancer Survivors in a Tertiary Care Hospital, Muzaffarabad: A Cross-Sectional Study.

BACKGROUND: Breast cancer is the most commonly diagnosed cancer among women worldwide and remains a major cause of cancer-related morbidity and mortality. Cancer-related stigma may adversely affect social relationships, psychological well-being, and financial security. Stigma affects the quality of life, treatment adherence, and mental health. The present study examined the associations between participant characteristics and stigma among breast cancer survivors in Muzaffarabad. METHODS: A total of 124 women aged ≥ 18 years with stage I-III breast cancer were recruited through consecutive non-probability sampling, of whom 101 with complete responses were included in the final analysis. The data were collected using a questionnaire adapted from Jin et al. (2021) and included questions on socio-demographics and factors associated with stigma, which were evaluated using components of the social impact scale, such as social rejection, financial burden, and psychological impact. Data were analyzed using Jamovi version 2.6.44.0. Associations between continuous stigma domain scores and participants' sociodemographic and clinical characteristics were assessed using Mann-Whitney U and Kruskal-Wallis tests. Statistical significance was set at p < 0.05. RESULTS: The majority of respondents were aged 45-59 years (59.4%), married (88.0%), and housewives (78.2%). Mean domain scores were 21.1 ± 3.9 for social rejection (possible range 7-28), 6.1 ± 0.5 for financial hardship (2-8), and 36.4 ± 4.5 for psychological impact (12-48). Because the domains contain different numbers of items, these scores should not be interpreted as direct comparisons of stigma burden. Financial hardship scores differed across disease stages. However, no clear directional trend was observed, and the small number of participants in Stage I limits the interpretation of subgroup differences. Therefore, this finding should be considered exploratory. CONCLUSION: Breast cancer survivors experienced substantial stigma-related experiences across social, financial, and psychological domains. Although most sociodemographic and clinical characteristics were not significantly associated with stigma scores, financial hardship varied significantly across disease stages. However, because the Stage I subgroup was very small, these findings should be interpreted cautiously, and the observed differences do not indicate a consistent increase in financial hardship with advancing disease stage.