Psychological distress and unmet supportive care needs in melanoma-survivors and high-risk patients for melanoma: A Swiss cross-sectional study

Background: Many melanoma patients experience worry, anxiety, and distress. Screening for psychological distress can facilitate early identification and management. However, little is known about such distress in melanoma survivors (MS) and patients at high risk for melanoma (HRM). Objectives: The primary outcome was to assess the melanoma-related worry in MS and HRM patients. Additionally, a secondary outcome was to determine the optimal Distress Thermometer (DT) cut-off for identifying those needing psycho-oncological support. Methods: We prospectively collected the distress-related patient-reported outcomes at the Department of Dermatology of the University Hospital in Basel, Switzerland, between 01/2021 and 01/2024. Validated questionnaires including the DT, Melanoma Worry Scale (MWS), Patient Health Questionnaire (PHQ-8), and Generalized Anxiety Disorder (GAD-7) were used to assess the primary outcome. For the secondary outcome, receiver operating characteristic (ROC) analysis were used to estimate the optimal DT cut-off. Conclusions: While MS exhibit greater disease-specific worry, HRM show increased general distress, underscoring distinct psycho-oncological needs. Adopting tailored DT cut-offs (≥3 for MS, ≥6 for HRM) may improve the detection of clinically relevant distress in these subgroups. Importantly, however, interest in psychological support was observed across all DT scores, indicating the need for flexible, patient-centred approaches. These findings highlight the unmet need for psychosocial care in both MS and HRM populations and could aid dermatologists to screen patients in future practice regularly.