Predictors of distress among individuals with gastric cancer.

Abstract

96 Background: With improving survival, gastric cancer patients face long-term quality of life concerns, including management of persistent symptoms and maintenance of social activity. We examined psychosocial distress and areas of concern in a national sample of gastric patients. Methods: Using data from the Cancer Support Community’s Cancer Experience Registry, our sample included 72 patients with a primary diagnosis of stomach (54%), esophageal (36%), or GIST (11%) cancer. Participants reported cancer-related distress using CancerSupportSource®, a 25-item tool with a 2-item anxiety risk subscale, 2-item depression risk subscale, and four additional subscales measuring symptom burden, body/healthy lifestyle, healthcare team communication, and relationship concerns. We used logistic regression to estimate which of these subscales influence risk for clinically significant anxiety and depression controlling for demographic/clinical variables that were associated with anxiety and depression risk in bivariate analysis. Results: Our sample was 62% female, 80% White, and averaged 58 years of age ( SD = 13). 24% were diagnosed less than one year before participating. 33% were ever diagnosed as metastatic. 42% had received surgery. 60% were at risk for clinically significant anxiety and 50% for clinically significant depression. In regression models, relationship concerns were significantly associated with greater risk for anxiety ( OR = 1.5; p < .05) and depression ( OR = 1.7; p < .05). Greater concern with healthcare team communication was associated with anxiety risk in bivariate analysis ( r = .41, p < .01), but the association was only a trend in the multivariate model ( OR = 1.4; p = .06). Similarly symptom burden concern was associated with depression risk in bivariate analysis ( r = .57, p < .01) but only a trend in multivariate analysis ( OR = 1.2; p = .06). Conclusions: Relationship concerns predicted risk for clinically significant anxiety and depression among stomach, esophageal, and GIST patients. Healthcare team communication and symptom burden concerns were also associated with anxiety and depression risk. Results highlight the need for constructive patient-provider communication, particularly around relationships and symptoms. Clinical trial information: NCT02333604.