1425MO - Use of psychosocial services and 1-year mortality among newly diagnosed and distressed cancer patients: A real-world study

Background

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.

Methods

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.

Results

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.

Conclusions

This large real-world study suggests that timely psychosocial care would benefit newly diagnosed distressed cancer patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.