RANDOMIZED TRIAL OF A PSYCHOLOGIC DISTRESS SCREENING-PROGRAM AFTER BREAST-CANCER - EFFECTS ON QUALITY-OF-LIFE

Purpose: Although psychosocial intervention can reduce psychosocial di stress following breast cancer, many women who are experiencing proble ms are not identified and offered additional help. This trial assessed effects on quality of life of psychologic distress screening among ne wly diagnosed, nonmetastatic breast cancer patients. Patients and Meth ods: From 1990 to 1992, all eligible patients in one regional breast c ancer center were identified and offered study participation. Women in both control and experimental groups received brief psychosocial inte rvention from a social worker at initial treatment. The experimental g roup also had monthly telephone screening of distress levels using a b rief, validated instrument, with additional psychosocial intervention offered only to those with high distress at screening. Results: Among 282 eligible patients, 89% were randomized and completed the study. pa rticipants' psychosocial distress levels decreased over the study peri od (P = .0001). However, no between-group differences were observed. M ean distress scores among control and experimental women at 0-, 3-, an d 12-month interviews were 20.7 and 20.4, 15.5 and 15.0, and 14.6 and 13.5, respectively. No between-group differences were observed with re spect to physical health, functional status, social and leisure activi ties, return to work, or marital satisfaction. Conclusion: Our results indicate that, among patients who receive a minimal psychosocial inte rvention as part of their initial cancer care, ct distress screening p rogram does not improve quality of life. Minimal psychosocial interven tion at initial treatment may be effective in reducing distress, thus making it difficult to obtain additional benefit from a screening prog ram. (C) 1996 by American Society of Clinical Oncology.