Although the American College of Surgeons’ Commission on Cancer (CoC) has required routine screening for distress among cancer survivors since 2016, a study published in JCO Oncology Practice found a gap in routine distress screening at CoC-accredited oncology programs.

Up to 50% of cancer survivors experience psychosocial distress during their cancer saga, according to researchers. Screening for distress provides an opportunity for clinicians to identify and discuss psychosocial concerns with patients. Previous publications have identified racial disparities and a gap in distress screening care among survivors of lung and ovarian cancers.

For this study, medical records from 2018 to 2020 at 21 CoC-accredited facilities were retrospectively reviewed. A total of 2258 survivors of lung cancer (1618) or ovarian cancer (640) were evaluated for documented distress screening.

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The study population comprised 61.4% women, 77.2% were White, 34.1% had stage IV cancer, 60.3% were diagnosed at 65 years or older, and 20.7% had a history of mental health issues.

Overall, 56.2% of lung cancer and 51.1% of ovarian cancer survivors had documented distress screening (P =.05).

At distress screening, patients were found to have physical symptoms (44.2%), emotional problems (37.4%), and practical problems (21.6%). Patients in distress were referred to an oncology social worker (36.4%) or nurse navigator (23.9%), among others.

Lung cancer survivors were more likely than ovarian cancer survivors to report having no distress (32.5% and 23.7%, respectively; P <.001). Ovarian cancer survivors were more likely to say their reason for feeling distressed was physical symptoms (51.4% vs 40.6%; P <.001).

When compared with White cancer survivors, Black cancer survivors were more likely to decline further services (9.7% and 31.5%, respectively) and less likely to have no need for additional services identified (25.8% and 15.1%, respectively).

The major limitation of this study was that data collection and documentation differed across sites.


Rohan EA, Gallaway MS, Huang GC, et al. Disparities in psychosocial distress screening and management of lung and ovarian cancer survivors. JCO Oncol Pract. Published online August 8, 2022. doi:10.1200/OP.22.00078

This article originally appeared on Oncology Nurse Advisor