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Attend this session at the
2019 ASCO Annual Meeting!

Session: Symptoms and Survivorship

Type: Poster Session

Time: Monday June 3, 1:15 PM to 4:15 PM

Location: Hall A

Correlates of distress for cancer patients: Results from multi-institution use of holistic patient-reported screening tool.

Palliative Care and Symptom Management

Symptoms and Survivorship

2019 ASCO Annual Meeting

Abstract No:

Poster Board Number:
Poster Session (Board #279)

J Clin Oncol 37, 2019 (suppl; abstr 11587)

Author(s): Christine B. Weldon, James I. Gerhart, Frank J. Penedo, Paramjeet Khosla, Betty Roggenkamp, Mary Pasquinelli, Joanna Martin, Teresa Lillis, Shelly S. Lo, Lawrence Eric Feldman, Catherine Deamant, Rosa Berardi, Harry Miranda, Carol Newsom, Anne Bowman, Julia Rachel Trosman; Northwestern University Feinberg School of Medicine, Chicago, IL; Central Michigan University, Mount Pleasant, ME; Mount Sinai Hospital, Chicago, IL; Center for Business Models in Healthcare, Chicago, IL; University of Illinois Hospital and Health Sciences System, Chicago, IL; Jesse Brown VA Medical Center, Chicago, IL; Rush University Medical Center, Chicago, IL; Loyola University Medical Center, Maywood, IL; University of Illinois at Chicago Cancer Center, Chicago, IL; Cook County Hospital and Health System, Chicago, IL; Coleman Foundation, Chicago, IL; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; Mercy Hospital and Medical Center, Chicago, IL; UnityPoint Health Methodist, Peoria, IL

Abstract Disclosures


Background: The Commission on Cancer (CoC) Standard 3.2 requires distress screening and indicated action for cancer patients. NCCN and ASCO supportive care and age-related guidelines include patient reported concerns beyond distress. This study compares PHQ4 scores to other patient reported concerns. Methods: The Coleman Supportive Oncology Collaborative aggregated “best of” screening tools to assess patient reported needs and concerns aligned with CoC, NCCN and ASCO guidance. This supportive care screening tool was implemented at 8 sites from July 2015 thru July 2018. Analysis used chi squared test. Results: Most patients, 86% (10,635/12,295), reported one plus concerns and/or above threshold scores on PHQ4, PROMIS Pain, Fatigue or Physical Function. A chi squared comparison of patients with at least mild distress on PHQ4 to patients with no distress resulted in p values < .0001 for every screening category. Conclusions: Patients with a PHQ4 distress score of mild, moderate or severe also reported statistically significant levels of practical, family, physical, nutrition and treatment concerns. These patients also scored threshold levels for PROMIS Pain, Fatigue, and Physical Function. Screening only for distress without screening for other patient concerns may direct patients to services that do not address or focus on the underlying cause of the distress.

Screening ItemEndorsed concern or threshold score
(n = 12,295)
RateAverageStandard DeviationMild+ PHQ4 vs lowerModerate+ PHQ4 vs lowerSevere+ PHQ4 vs lower
Patient Health Questionnaire 4 (PHQ4)1.892.88
Mild +, score of 3.0+356429%
Moderate +, 6.0+143012%
Severe +, 9.0+5164%
Practical Concerns316826%0.420.86< 0.0001< 0.0001< 0.0001
Family Concerns311525%0.420.85< 0.0001< 0.0001< 0.0001
Physical Concerns757362%1.982.42< 0.0001< 0.0001< 0.0001
2+ Physical Concerns547545%< 0.0001< 0.0001< 0.0001
Nutrition Concerns396132%0.880.85< 0.0001< 0.0001< 0.0001
PROMIS Pain, 5+428435%5.373.45< 0.0001< 0.0001< 0.0001
PROMIS Fatigue, 10+368330%8.854.60< 0.0001< 0.0001< 0.0001
PROMIS Physical Function, 15-180015%19.526.35< 0.0001< 0.0001< 0.0001
Treatment Concerns550945%1.191.51< 0.0001< 0.0001< 0.0001

Other Abstracts in this Sub-Category:


1. A phase II RCT of high-dose vitamin D supplementation and exercise for cancer treatment-induced bone loss in breast cancer patients on aromatase inhibitors.

Meeting: 2019 ASCO Annual Meeting Abstract No: 11500 First Author: Luke Joseph Peppone
Category: Symptoms and Survivorship - Palliative Care and Symptom Management


2. A randomized trial comparing four-weekly versus 12-weekly administration of bone-targeted agents (denosumab, zoledronate, or pamidronate) in patients with bone metastases from either breast or castration-resistant prostate cancer.

Meeting: 2019 ASCO Annual Meeting Abstract No: 11501 First Author: Mark J. Clemons
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3. A randomized, double-blind, placebo-controlled phase III trial evaluating olanzapine 5 mg combined with standard antiemetic therapy for the prevention of chemotherapy-induced nausea and vomiting in patients receiving cisplatin-based chemotherapy: J-FORCE Study.

Meeting: 2019 ASCO Annual Meeting Abstract No: 11503 First Author: Hironobu Hashimoto
Category: Symptoms and Survivorship - Palliative Care and Symptom Management