Cancer-related distress: Revisiting the utility of the national comprehensive cancer network distress thermometer problem list in women with gynecologic cancers

Patricia I. Jewett, Deanna Teoh, Sue Petzel, Heewon Lee, Audrey Messelt, Jeffrey Kendall, Dorothy Hatsukami, Susan A. Everson-Rose, Anne H. Blaes, Rachel I. Vogel

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


PURPOSE The Distress Thermometer (DT) includes a measure of cancer-related distress and a list of self-reported problems. This study evaluated the utility of the DT problem list in identifying concerns most associated with distress and poorer quality of life (QOL) in survivors of gynecologic cancer. METHODS Demographic, clinical, psychosocial functioning, and DT data were described among 355 women participating in a gynecologic cancer cohort. Problems from the DT list were ranked by prevalence, distress, and QOL. Logistic regression models explored factors associated with problems that were common ($ 25% prevalence) and associated with distress and QOL. RESULTS The average age of participants was 59.9 years (standard deviation [SD], 10.8 years). Most participants were non-Hispanic white (97%) and had ovarian (44%) or uterine (42%) cancer. The mean DT score was 2.7 (SD, 2.7); participants reported a mean of 7.3 problems (SD, 5.9 problems). The most common problems were fatigue (53.6%), worry (49.9%), and tingling (46.3%); least common problems were childcare (2.1%), fevers (2.1%), and substance abuse (1.1%). Report of some common problems, including tingling, sleep, memory, skin issues, and appearance, was not associated with large differences in distress or QOL. In contrast, some rarer problems such as childcare, treatment decisions, eating, housing, nausea, and bathing/dressing were associated with worse distress or QOL. Younger age, lower income, and chemotherapy were risk factors across common problems that were associated with worse distress or QOL (fatigue, nervousness, sadness, fears, and pain). CONCLUSION The DT problem list did not easily identify concerns most associated with distress and low QOL in patients with gynecologic cancer. Adaptations that enable patients to report their most distressing concerns would enhance clinical utility of this commonly used tool.

Original languageEnglish (US)
Pages (from-to)E649-E659
JournalJCO Oncology Practice
Issue number8
StatePublished - 2020

Bibliographical note

Funding Information:
R.I.V. is the Masonic Cancer Center Women’s Health Scholar, which is sponsored by the University of Minnesota Masonic Cancer Center (National Cancer Institute/National Institutes of Health Grant No. P30 CA77598 [Primary Investigator D. Yee]), a comprehensive cancer center designated by the National Cancer Institute, and administrated by the University of Minnesota Deborah E. Powell Center for Women’s Health. Support for the use of REDCap was provided by Grant No. UL1TR002494 from the National Institutes of Health’s National Center for Advancing Translational Sciences.

Publisher Copyright:
© 2020 by American Society of Clinical Oncology.

Copyright 2020 Elsevier B.V., All rights reserved.

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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