Background: Cancer-related distress is a multifactorial experience affecting patients’ quality of life and treatment outcomes. Despite global efforts to promote distress screening, data from low-resource settings remain limited. Objectives: To assess the prevalence, severity, and contributors to distress among cancer patients in a tertiary oncology center in Lebanon and identify palliative care (PC) referral gaps. Design: Cross-sectional secondary analysis of a quality improvement initiative. Setting/Subjects: Adult cancer patients receiving treatment at the infusion unit of the Naef K. Basile Cancer Institute, American University of Beirut Medical Center. Measurements: Distress was evaluated using the National Comprehensive Cancer Network Distress Thermometer (NCCN DT). Patients with DT scores ≥ 4 completed the NCCN Problem List. Sociodemographic and clinical data were extracted from institutional records. Results: Among 670 patients (mean age: 56 ± 15 years; 56% female), 76% reported moderate-to-severe distress (score ≥ 4), and 37% experienced severe distress (score > 7). Distress was significantly higher in females ( p < 0.001) and patients with solid tumors ( p = 0.015). Key distress domains included physical (93%), emotional (83%), and practical problems (70%). Only 1% of distressed patients had prior PC referrals. Conclusions: Distress is highly prevalent among cancer patients in Lebanon, particularly among women and those with solid tumors. Despite strong evidence for the benefits of early PC, referral rates remain alarmingly low. Routine distress screening and integration of PC services are urgently needed to address this gap and improve holistic cancer care in low-resource settings.
Yamout et al. (Thu,) studied this question.