Elevated distress among patients undergoing screening for lung cancer

Abstract

Objective: Low-dose CT scanning has recently been recommended to screen patients at elevated risk of developing lung cancer, however, limited data exist describing distress experienced by this at-risk population. The objective of this study is to describe the prevalence and risk factors of high distress among patients undergoing screening for lung cancer.

Methods: The validated National Comprehensive Cancer Network Distress Thermometer (DT) was used to evaluate distress prior to and following lung cancer screening among 228 patients attending the Center for Lung Cancer Screening and Prevention at the Stony Brook Cancer Center between September 30, 2013 and September 29, 2014. Clinically significant distress was defined by a score ≥ 4 on the DT instrument and logistic regression models were used to evaluate factors associated with high distress.

Results: Forty-three percent of study participants experienced elevated distress prior to screening, while approximately one-third of patients reported distress scores ≥ 4 post-screening. Risk factors for elevated distress before screening included female gender (OR = 2.68; 95% CI [1.51, 4.77]) and having a positive family history of lung cancer (OR = 2.02 [1.04, 3.91]), while significant associations with post-screening distress were found among females (OR = 3.16 [1.73, 5.80]), current smokers (1.85 [1.00, 3.42]) and those with a positive personal history of a non-cancerous lung diagnosis (OR = 1.87 [1.00, 3.51]).

Conclusions: The lung cancer screening population is a vulnerable group burdened by increased levels of distress. The screening visit represents a unique opportunity to not only educate patients about lung health and smoking cessation but additionally to address issues related to psychological wellness.