Exploring Colorectal Cancer Stigma in Nigeria: Insights and Mitigation Strategies

Purpose: Colorectal cancer (CRC) is the fourth most common and fatal malignancy in Nigeria. CRC- related stigma (CRC stigma) contributes to delayed diagnosis and treatment initiation leading to worse outcomes and poor quality of life. Understanding the drivers of CRC stigma, previously unstudied in a Nigerian context, can lead to improved oncologic and survivorship outcomes. We explored social perceptions, attitudes, and behaviors regarding CRC stigma in Nigeria to highlight its impact and identify strategies for mitigating its consequences. Methods: We purposively recruited 20 individuals diagnosed with or at risk for CRC, 30 caregivers, and 16 healthcare professionals from Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria, to participate in 42 individual in-depth interviews and four focus group discussions between September 2022 and April 2023. Qualitative content analysis was used to identify and describe drivers of CRC-related stigma, its impact on patients, and potential mitigating strategies. Results: Although some participants noted improved community attitudes towards CRC as awareness and outcomes have improved, illness-related and CRC-specific social stigma remained prevalent. Stigma often arose from cultural misperceptions about cancer (e.g., contagious, punishment/curse, “death sentence”) or perceptibility of symptoms (e.g., malodor, bowel dysfunction, colostomy). Participants also noted that family and community members may distance themselves from patients with cancer to avoid having to contribute to their care financially. CRC stigma resulted in social isolation, shame, mistrust of community and family members, abandonment, and delayed health-seeking behaviors. The psychosocial burden of this stigma was at times felt to be worse than the burden of the disease itself. Suggested strategies for mitigating CRC stigma included community awareness campaigns, early diagnosis programs, patient education, and training sessions for improved colostomy management. Conclusion: Our findings suggest that CRC stigma is pervasive in Nigeria and contributes to delayed presentation, progression to advanced disease, worse oncologic outcomes, and social abandonment among patients with CRC. Interventions promoting community awareness, early diagnosis, and timely treatment can lessen the psychosocial impact of stigma and improve long-term outcomes. Citation Format: Catherine N. Zivanov, Israel A. Owoade, Erica J. Mann, Oluwadayomi E. Adedeji, Grace I. Bassey, Oluwaleke J. Fayenuwo, Titilope A. Adeyanju, Christopher O. Bamidele, Akintayo T. Olaniyan, Adeoluwa O. Adeleye, Oluwabusayomi R. Ademakinwa, Adeyemi A. Amuda, Olaoti O. Ogundare, H. Dean Hosgood, Rivka Kahn, Cristina Olcese, Grace Fitzgerald, Olalekan Olasehinde, Funmilola O. Wuraola, Tajudeen Mohammed, Matthew Bojuwoye, Adewale Aderounmu, T. Peter Kingham, Olusegun I. Alatise, Adebola A. Adedimeji. Understanding Colorectal Cancer–Related Stigma in Nigeria: A Qualitative Analysis [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 6.