# Evaluation of community stigma toward childhood cancer in Tanzania

> **NIH NIH P30** · DUKE UNIVERSITY · 2021 · $186,499

## Abstract

Each year, low- and middle-income countries (LMICs) account for over 85% of the 400,000 newly
diagnosed pediatric cancer cases. Survival rates in LMICs are 5-25% compared to 80% in high-
income countries (HICs). Almost 1/3 of the survival difference can be attributed to treatment
abandonment, defined as the failure to initiate or sustain treatment during four or more successive
weeks, which is influenced by health system and individual level barriers. In Tanzania, prior
research with caregivers of children with cancer and expert health care providers explored how
misbeliefs and perceived community reaction and fears lead to delays in health seeking behavior
and increased treatment abandonment. To target this internalized stigma and improve outcomes,
tailored interventions are needed at the community level. However, the community perspective
on stigma towards childhood cancer has not been evaluated, a critical knowledge gap. The
current proposal will complete a comprehensive assessment to explore the unique stigmatization
beliefs related to pediatric cancer and terminology used among the non-patient community
population. This information will be used to inform the adaptation of a previously developed
measure of cancer stigma, which can be used to monitor and evaluate the impact of community-
based interventions targeting pediatric cancer stigma in LMICs.
 In 2014, the Duke Global Cancer Initiative was created, including a partnership between
Duke University and Bugando Medical Centre in Mwanza Tanzania to improve the quality of
global pediatric cancer care through research and clinical capacity development. This program is
supported by the Duke Cancer Institute CCSG P30 grant (2P30CA014236-46) whose aims
include the integration of all cancer-related research activities at Duke including global cancer
capacity development. Previous P30 NCI supplement sponsored research successfully
implemented interventions targeting both health system inefficiencies and individual barriers to
care, including the development of a pediatric cancer clinical database, a patient navigation
program, and establishment of a hostel program for patients and their families to stay during
treatment. Although reduced, 32% of patients still abandon treatment. Of the known factors
contributing to abandonment, we have yet to develop and intervention to address the community
perception of childhood cancer. The support from this administrative supplement will allow us to
complete our comprehensive evaluation of the impact of stigma on childhood cancer treatment
abandonment, adding community-based data to our previously completed patient and provider
level evaluations. This critical data will inform the development of targeted community-based
stigma reduction intervention, continuing to drive the field of childhood global cancer forward and
further reduce the immense global survival disparity.

## Key facts

- **NIH application ID:** 10405352
- **Project number:** 3P30CA014236-47S3
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Michael B Kastan
- **Activity code:** P30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $186,499
- **Award type:** 3
- **Project period:** 1997-01-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10405352

## Citation

> US National Institutes of Health, RePORTER application 10405352, Evaluation of community stigma toward childhood cancer in Tanzania (3P30CA014236-47S3). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10405352. Licensed CC0.

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