Distress Screening in Head and Neck Cancer Patients Planned for Cancer-Directed Radiotherapy

Objective/Hypothesis: To estimate the prevalence of baseline clinically significant distress (distress score ≥ 4) in head and neck cancer patients planned and treated with radical intent radiotherapy using the National Comprehensive Cancer Network Distress Thermometer (DT) and assess factors predictive of distress. Study Design: Cross-sectional study. Methods: This was a cross-sectional study evaluating distress in 600 head and neck cancer patients undergoing radiation therapy. The DT was used to screen patients for distress at baseline before radiotherapy. Results: The median distress score of the entire cohort was 4 interquartile range (IQR) (IQR: 3–5), and 340 patients (56.7%) had clinically significant distress. On univariate analysis, the causal factors predictive of distress were low socioeconomic status (P =.04), presence of proliferative growth at presentation (P =.008), site of the tumor (oral cavity, P =.02), comorbidity (P =.04), and presence of Ryle's tube or tracheostomy tube at baseline (P =.01). Low socioeconomic status was significant (P =.04) on multivariate analysis for high levels of distress. Conclusions: Among head and neck cancer patients, 56% of patients had clinically significant baseline distress, and patients with low socioeconomic status had high distress. There is a need for interventions to mitigate distress. Level of evidence: 4 Laryngoscope, 2021.