The National Comprehensive Cancer Network (NCCN) Guidelines for Distress Management recommend that cancer patients should be promptly treated if the patient are distressed (more than 4 DT score). Numerous interventions, such as cognitive-behavioral therapy (CBT), relaxation, and psychosocial therapy, have been shown in randomized controlled trials to be efficacious in addressing distress in patients with cancer. However, many of these interventions have a low potential for implementation as part of routine care because of their complexity, the number of resources required to deliver them, and the limited range of distress-related problems they address. We aimed to evaluate whether psychosocial services for newly diagnosed distressed cancer patients would reduce the risk of 1 year mortality using real-world data.
We conducted a retrospective cohort study of 4,961 newly diagnosed cancer patients who underwent distress screening within three months after diagnosis and reported distress scores of 4 or higher between July 2014 and December 2017. For this study, it was considered that a patient used a psychosocial service if they had in-depth counseling by a social worker, visited the Supportive Care Center (SCC), or took any education program at the Cancer Education Center (CEC). The primary endpoint was all-cause mortality within one year until December 31, 2018.
There were 18% had access to psychosocial services. During 4,652 person-years of follow-up, patients who used psychosocial services had a lower risk of 1-year mortality than those who did not (Hazard Ratio (HR) = 0.64; 95% CI = 0.47, 0.87). Among participants who used psychosocial services, the fully adjusted HR (95% CI) for 1-year mortality among participants who used psychosocial services within a month after distress screening was 0.52 (95% CI = 0.28, 0.98) compared to participants who used psychosocial services a month after screening. The association between psychosocial services and all-cause mortality was consistent between all subgroups analyzed.
This large real-world study suggests that timely psychosocial care would benefit newly diagnosed distressed cancer patients.
Clinical trial identification
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Has not received any funding.
All authors have declared no conflicts of interest.