Predictors of Anxiety, Depression, and Somatization: A Prospective Study of 1807 Cancer Patients Short title

Cancer causes distress, resulting in anxiety, depression or somatization. The aim was to investigate sociodemographic, clinical, and psychological factors associated with psychological distress in cancer patients. This prospective and multicenter study, conducted by the Spanish Society of Medical Oncology (SEOM), included two cohorts of patients with cancer (localized resected or advanced unresectable). They completed surveys to evaluate psychological distress (BSI-18), coping (MINI-MAC), and spirituality (FACIT-sp). A multivariable logistic regression analysis was conducted. Between 2019-2022, 1807 patients were evaluated, mostly women (54%), average age 64 years. The most frequent primary cancers were colorectal (30%), breast (25%) and lung (18%). Older individuals (OR0.98, CI95% 0.97-0.99), and males (OR0.66, CI95% 0.51-0.84 and OR0.75, CI95% 0.58-0.97) had less anxiety and depression. Colorectal cancer patients had less depression (OR0.67, CI95% 0.47-0.95) and somatization (OR0.71, CI95% 0.52-0.97). Patients with localized cancer and with spiritual beliefs had lower levels of psychological distress, while those with anxious preoccupation had higher levels. After treatment, patients with pre-existing distress and anxious preoccupation experienced an increase in psychological distress while those with localized cancer showed reduced levels of anxiety and somatization. This study suggests that age, sex, extension and location of cancer, coping and spirituality influence psychological distress in cancer patients.