Does age contribute to distress in new geriatric oncology patients?

Abstract

e24023 Background: As part of routine practice at the Lifespan Cancer Institute (LCI), all new patients are screened with the NCCN Distress Thermometer (DT). There is little to no data comparing initial distress levels among patients 65 and older recently diagnosed with cancer and how this might change with increasing age. This study sought to describe distress at initial presentation among two cohorts: patients 65 to 74 years and those 75 years and over. Methods: We have retrospectively reviewed 1800 patients at Lifespan Cancer Institute so far, all of whom were initially seen between the years 2014-2017. Data related to demographics, tumor type, initial distress score, and sources of distress were gathered using our electronic medical records. Categorical data were analyzed using Fisher’s Exact Test or Chi-Square. Multinomial logistic regression was performed for multivariate analysis. All analyses were performed in STATA 15.0. Results: At time of diagnosis, 898 (49.9%) patients were over 65 years. Of those, 577 (64%) had distress thermometers and were included in this analysis. The median age was 72 (range 65 to 92), 66.9% were female, and 42.5% were married or partnered; 393 (68.1%) were under 75 years and 184 (31.9%) were 75 or older. The major cancers represented included breast (44%), lung (19.6%), and prostate (17%) cancers. The presence of severe distress (DT score of 4 or higher) did not significantly differ by age cohort (45.3 versus 45.7%, respectively, p > 0.5) but differed by tumor group (p < 0.001). Compared to people under 75 years, more of those 75 and older reported sadness (27 versus 20%, respectively, p < 0.05), issues with memory and concentration (12 versus 7.6%, p < 0.1) and trouble with getting around (14.7 versus 8.4%, p < 0.05). On multinomial logistic regression, only tumor group and reporting sadness on the DT remained significant factors for severe distress, whereas age did not. Conclusions: There is no significant difference in distress reporting among geriatric patients with cancer who are under 75 compared to those 75 and older. Tumor type and sadness at the initial presentation were associated with severe distress in this group of people.