The following article features coverage from the American Society of Clinical Oncology 2019 meeting. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

Patient-reported outcomes (PROs) identified 5 symptoms that consistently predict clinically significant distress in patients with cancer, according to research presented at the 2019 American Society of Clinical Oncology (ASCO) Annual meeting, held in Chicago.

ASCO and National Comprehensive Cancer Network (NCCN) guidelines recommend screening for multifactorial distress in patients with cancer. Early intervention and improved clinical outcomes are based on clinicians’ ability to recognize predictors of cancer-related distress. Therefore, researchers at Levine Cancer Institute in Charlotte, North Carolina, sought to identify the symptoms most likely to predict distress in patients.

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The researchers collected PROs from 42 practice locations through electronic distress screening (EDS). Median age in the study population was 59 (IQR 18-101), and 65% were female. The EDS consisted of 39 questions related to distress, cancer symptoms/side effects, malnutrition, depression, anxiety, social/family support, and financial and spiritual concerns. Predictors of distress for completed screens overall (27,106 patients), registry matched (9438), and registry matched and within 60 days of diagnosis (5894) were determined by multivariate analysis and logistic regressions.

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Five symptoms were found to consistently predict clinically significant distress (rated as 4 or higher), which were anxiety, fatigue, pain, poor emotional coping, and sleep. Factors that did not independently predict distress were diagnosis, staging at time of diagnosis, and timing of EDS.

Predictors of distress were consistently reported along the continuum, which demonstrates the importance of early symptom identification. However, these predictors varied across geographic regions. Facilities can use EDS results to custom tailor supportive oncology programs to meet the needs of their patient populations.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original abstract for a full list of disclosures.


Meadors PL, Trufan SJ, Walsh K, Walsh D. Patient reported outcomes and predictors of distress. Poster presentation at: 2019 ASCO Annual Meeting; May 31 to June 4, 2019; Chicago, IL. Abstract 6559.