From Stigma to Strength: Shifting the Narrative in Cervical Cancer Care With Gretchen McNally, PhD, MPH, ANP-BC, AOCNP®

Understanding Cervical Cancer Stigma

“Cervical cancer is highly stigmatized, mainly due to its association with human papillomavirus (HPV), which is considered a sexually transmitted illness,” Dr. McNally explains. This link to a sexually transmitted infection (STI) often leads to misconceptions and judgment about patients’ sexual behavior, compounding the stigma. “The association with an STI and the stigma of sexual behavior in general create significant barriers for patients,” she notes.

Impact of Stigma on Care and Outcomes

Stigma is not just a social issue—it directly affects patient care. “Stigma really has been recognized as a major barrier to care across the entire cancer continuum, from prevention to survivorship,” Dr. McNally says. She highlights that stigma can deter individuals from seeking HPV vaccination, participating in screening, or following up on abnormal results. “This leads to treatment delays or forgoing treatment altogether, and the stigma continues into survivorship,” she adds.

Research and Recommendations

Dr. McNally’s recent work, conducted in collaboration with the American Cancer Society’s National Round Table on Cervical Cancer, involved a comprehensive review of cervical cancer stigma. “I did a deep dive into cervical cancer stigma, organizing the literature from 2010 to the present, and made recommendations for moving forward,” she shares. Her research utilized the Health Stigma and Discrimination Framework and found that early messaging about the HPV vaccine—initially marketed only for females and for genital warts—contributed to public misunderstanding and stigma.

She recommends applying a “universal precautions” approach, similar to what was adopted during the human immunodeficiency virus (HIV) epidemic. “Everyone is treated the same, which decreases stigma. I believe we should use this framework, along with changing the language around cervical cancer, to reduce stigma at all levels,” Dr. McNally advises.

Practical Steps for Clinicians

Oncology clinicians play a crucial role in reducing stigma. “Start to incorporate non-stigmatizing language into all conversations—with colleagues, staff, patients, and even family and friends,” Dr. McNally urges. She emphasizes that HPV exposure is extremely common: “Approximately 90% of women have been exposed to HPV in their life. The majority of people are exposed, but not all develop cervical cancer.” She encourages clinicians to lead by example and educate others through sensitive communication.

For guidance, Dr. McNally recommends the National Comprehensive Cancer Network (NCCN) language guidelines for culturally sensitive care, which provide practical examples for clinicians.

Key Takeaways

• Cervical cancer stigma is rooted in its association with HPV and sexual behavior, often leading to misconceptions and barriers to prevention and care
• Stigma affects every stage of the cancer continuum, from vaccination and screening to treatment and survivorship
• Universal precautions and sensitive language can help reduce stigma and improve patient outcomes
• Clinicians should use resources like the NCCN guidelines to foster non-stigmatizing, culturally sensitive communication
• The HPV vaccine is a powerful tool for cancer prevention, and everyone eligible should be encouraged to receive it

Dr. McNally concludes with a message for Women’s Health Week: “We can eliminate cervical cancer through the HPV vaccine. It’s a cancer prevention vaccine, and everyone should consider it.”

About Dr. McNally

Gretchen McNally, PhD, MPH, ANP-BC, AOCNP®, is a Hematology Nurse Practitioner at The Ohio State University (OSU) Comprehensive Cancer Center and The James Cancer Hospital. She received her Doctorate in Nursing from OSU and has been a member of the hematology team at The James Cancer Hospital since 2007. Dr. McNally specializes in the care and treatment of patients with lymphomas, and she is passionate about reducing cancer stigma and providing high-quality, personalized care to her patients.