ASPO Abstracts
Disparities in Distress Screening in Lung and Ovarian Cancer Patients
Category: Cancer Health Disparities
Conference Year: 2021
Abstract Body:
Purpose of the Study: Lung and ovarian cancer patients have relatively low 5-year
survival rates and experience high levels of distress due to their diagnosis. We examined
the extent to which ovarian and lung cancer patients received Commission on Cancer
(CoC)-mandated distress screening (DS) and whether disparities exist based on
diagnosis, sociodemographic factors, or facility geography (urban/rural).
Methods: This mixed-method study included a quantitative review of DS documentation
and follow-up services provided using existing electronic health records (EHRs) and
qualitative inquiry of healthcare practitioners to ascertain facilitators and barriers to
implementing routine DS. We enrolled 21 CoC-accredited facilities across the United
States and examined EHRs of 2,258 survivors (1618 lung cancer survivors, 640 ovarian
cancer survivors) diagnosed in 2016 or 2017. Qualitative data collection consisted of
interviews and focus groups of health care practitioners at four sites.
Results: Documentation of DS was found in half (52%) of the EMRs reviewed.
Disparities existed across race/ethnicity, cancer type and stage, and facility
characteristics. White and African American survivors were screened for distress at
higher rates than Hispanic/Latino survivors. Ovarian cancer patients, those diagnosed at
later stages (stage 3 or 4), and patients in rural facilities were screened for distress more
often. Health care practitioners identified administering DS across several points in time,
using patient-administrated methods, and enhancing EHR infrastructure to better collect,
record, and retrieve DS data as ways to improve the DS process.
Conclusions: Despite the mandate for routine DS in CoC-accredited cancer care
facilities, gaps remain in how many and which patients are routinely screened for
distress. Additional focus on and outreach to lung cancer patients, Hispanic/Latino
patients, and patients at urban facilities may be considered. These study results may be
used to enhance the quality of cancer care delivery at facilities participating in this study
and may be translated to other settings to increase the number of cancer patients overall
who are screened for distress to ensure they receive appropriate psychosocial care.
Keywords: cancer survivors; distress screening; psychosocial; cancer