Smartwatch and physical education exam stress: the role of exercise self-efficacy and physical self-concept.

Cancer stigma is a hidden but consequential barrier to the diagnosis and treatment of cancer in sub-Saharan Africa, driven in no small part by its significant effects on mental health. With the incidence of cancer rising, interventions that address the multifaceted drivers of stigma are urgently needed. Despite the timely nature of this issue, there remain significant deficits in stigma-focused care across the region. This article highlights that stigma operates alongside myriad cultural and social structural factors that must be addressed in culturally sensitive ways to be effective. By synthesizing evidence across cultural, psychological and structural aspects of stigma, this article provides a comprehensive examination of a driving force behind increased cancer mortality. These insights can help guide policymakers, clinicians and global health professionals in designing multilevel interventions and supporting the lives of patients with cancer in sub-Saharan Africa. Cancer-related stigma is increasingly recognized as a significant yet largely unaddressed influence on cancer mortality due to stigma-driven screening avoidance, late presentation, low treatment adherence and worsened quality of life (Corrigan et al. ). Specifically, people affected by cancer in sub-Saharan Africa face a complex and interrelated set of challenges in a unique sociocultural environment, specifically in low-resource settings marked by inadequate infrastructure and lack of availability of high-quality cancer care (Tessema et al., ). While service-delivery factors are undoubtedly major contributors to poor outcomes, challenges are further exacerbated by pervasive stigma (Bray et al., ). Notably, cancer incidence is rapidly rising, and survival rates in sub-Saharan Africa are among the lowest globally (Henry et al., ). Addressing cancer stigma is therefore consistent with global mental health policy priorities, including the WHO’s Comprehensive Mental Health Action Plan 2013–2030, which calls for the integration of mental health into broader health systems and the reduction of stigma as a barrier to care-seeking (World Health Organization, ). In sub-Saharan Africa, stigma-reduction interventions that leverage existing community infrastructure represent a scalable pathway for expanding mental health support within cancer care systems. Stigma can operate in tandem with structural limitations, intensifying delays in recognition and treatment-seeking behavior. About 85% of cancer patients report experiencing at least one type of stigma (Squiers et al., ), and stigma can worsen psychological outcomes in cancer patients (Yilmaz et al., ). Specifically, in one study, negative attitudes toward cancer were associated with an ~2.5-fold higher likelihood of depression (Cho et al., ). Ultimately, worsening mental health and delayed diagnoses associated with stigma may contribute to excess mortality among cancer patients (Chang and Lai, ), underscoring the urgency of addressing cancer stigma in the sub-Saharan African region.