Problem-Related Distress and Quality of Life in Cancer Survivors Participating in a Community-Based Screening Program

As part of an initiative to validate a distress screening tool, the purpose of this analysis was to identify the sources of distress that have the greatest impact on quality of life (QOL). A cross-sectional group of 319 survivors (84% female; 83% white) of mixed cancer diagnosis (45% breast) who participated in a screening study at 14 community-based affiliates of the Cancer Support Community completed the Functional Assessment of Cancer Therapy-General version (FACT-G) scale and the Cancer Support Community Screener (CSCS), a validated distress screening tool that asks participants to rate the severity of 36 problem-related distress items. Findings from regression analysis showed eight items were significantly associated with QOL (adjusted R2 = 0.64; n = 284): feeling down or depressed (p = 0.002), worry about the future (p < 0.001), needing practical help at home (p = 0.003), fatigue (p < 0.001), physical appearance (p = 0.023), sleeping (p < 0.001), finding meaning or purpose in my life (p < 0.001), and feeling unsupported by my partner (p = 0.001). Fatigue (p < 0.001), pain (p < 0.001), side-effects of treatments (p < 0.001), needing practical help at home (p = 0.004), and finding community resources near where I live (p = 0.012) were significantly associated with physical well-being (adjusted R2 = 0.63; n = 294). Four items predicted social/family well-being (adjusted R2 = 0.38; n = 295): feeling isolated, alone or abandoned (p < 0.001); talking with family, children and friends (p < 0.001); feeling unsupported by my partner (p < 0.001); and finding meaning or purpose in my life (p = 0.003). Six items predicted emotional well-being (adjusted R2 = 0.62; n = 295): feeling anxious or fearful (p < 0.001); worry about the future (p < 0.001); feeling down or depressed (p < 0.001); questions and fear about end of life (p < 0.001); weight gain or loss (p = 0.022); and physical appearance (p = 0.048). Finally, worry about the future (p = 0.004), fatigue (p < 0.001), finding meaning or purpose in my life (p < 0.001), sleeping (p < 0.001), and needing practical help at home (p = 0.062) were significantly associated with functional well-being (adjusted R2 = 0.44; n = 303). The CSCS can be used to screen for problems related to key components of QOL.