A patient with a significant cancer is at risk for distress, especially if certain risk factors are present.


Risk factors associated with distress in a patient with cancer:

(1) history of substance abuse

(2) history of depression, anxiety or other psychiatric disorder

(3) history of suicide attempt

(4) history of physical and/or sexual abuse

(5) cognitive impairment

(6) presence of barriers to communication

(7) presence of a high level of comorbidity

(8) presence of social problems (see below)

(9) presence of serious religious or spiritual concerns


Social problems that may increase distress:

(1) conflicts with family and/or caregiver

(2) no or little social support

(3) living alone

(4) economic problems

(5) limited access to health care

(6) need to care for someone else, especially children


A patient with one or more of these risk factors should be screened for distress.


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