Differences in psychosocial stressors between black and white cancer patients

Abstract

For patients with cancer, acknowledgment of mental and emotional distress is critically important when developing and implementing a treatment plan. e psychosocial distress associated with cancer diagnosis and treatment can have an impact on a patient’s quality of life, inuence a patient’s ability to adhere to treatment regimens, and increase cost of care.1-4 Rates of depression have been reported to range from 8%-36%, with a 29% risk of anxiety in cancer patients.5, 6 Emotional distress is linked to increased hopelessness about their cancer diagnosis, increased issues with chronic pain, and negative treatment outcomes.7 Timely screening of psychosocial distress at the ‰rst clinical visit enables providers to make appropriate referrals to resources early in their course of treatment; however, referrals to psychosocial interventions remain infrequent nationwide in the United States.8 ere is some evidence of a di erential impact of cancer on mental health diagnoses between racial/ethnic groups; however, results are not entirely consistent across studies. Using the Kessler Pyschological Distress Scale (K6) score, Alcala and colleagues found that cancer was more detrimental to mental health for black patients than for nonHispanic white patients.9 Black breast cancer survivors have also been shown to be more likely to stop working during the early phases of their treatment, indicating that they and their physicians need to take steps to minimize long-term employment consequences.10 However, in a study of women with breast cancer, black women reported fewer depressive symptoms than did non-Hispanic whites.11 e American College of Surgeons’ Commission on Cancer (ACS CoC) developed a set of Continuum of Care standards in 2012, including the implementation of psychosocial distress screening for patients with cancer. Since 2015, all accredited cancer programs are now required to evaluate these patients for signs of distress during at least