Analysis of Sociodemographic and Disease Factors Associated with Psychological Distress among Newly Diagnosed Cancer Patients

Abstract

Cancer is the second leading cause of death in the United States, but it is estimated that there were 16.9 million cancer survivors in 2019, making it important to understand the negative impacts of cancer on physical and psychosocial aspects of quality of life. Psychological distress is one of the common adverse outcomes in cancer patients and survivors. In order to address psychological distress, the American College of Surgeons Commission on Cancer mandated Standard 3.2, which requires all comprehensive cancer centers to screen for psychological distress. Since the implementation of Standard 3.2, there have been several studies investigating factors associated with psychological distress in cancer patients. Efforts to implement distress screening have proven challenging due to the varied resources needed to evaluate the best tools to assess distress, ease of administration and the next steps after patients have been screened. This retrospective cross-sectional study of 1,227 newly diagnosed cancer patients from the Lombardi Comprehensive Cancer Center (LCCC) at MedStar Georgetown University Hospital (MGUH) sought to examine the sociodemographic and disease factors associated with distress, anxiety and depression and the most common problems that patients identify as sources of distress. Additionally, correlations between the NCCN Distress Thermometer (DT) and the PROMIS Depression and PROMIS Anxiety 6-item short forms were conducted. The significant associations found for psychological distress were age and cancer type. Upon examining the problem list, the top 5 items identified were: 1. fatigue, 2. coping with illness, 3. feeling anxious/fearful, 4. pain management and 5. sleep disturbance. Both PROMIS tools were shown to be significantly correlated with the Distress Thermometer although different variable associations for the PROMIS tools and Distress Thermometer were discovered. These findings suggest clinical implications for considering the use of the PROMIS tools in the oncology outpatient setting, at least as part of a further assessment to identify patients who might benefit from psychological services.