Analysis of psychosocial distress screening and needs assessment in adult survivors of childhood cancer.

160 Background: Childhood cancer survivors (CCS) face complex psychological late effects. The need for systematic screening for psychosocial distress has been clearly identified; however, less clarity exists around characterizing factors that might identify patients at higher risk to support targeted treatment. The purpose of this study was to examine the results of psychological screening in a clinic for adult survivors of childhood cancer using the validated NCCN Distress Screening Thermometer and modified Needs Assessment and exploring the results with other patient factors. Methods: Retrospective chart review was completed on 117 CCS seen in our Survivorship Transition Clinic (STC) between 2014 and 2017. The NCCN Distress Thermometer and Needs Assessment were administered to patients attending the STC. Results were then analyzed with a number of additional factors to explore association. These factors included intensity of treatment (by Children’s Hospital of Philadelphia Intensity of Treatment Rating scale or ITR3), gender, and age at diagnosis. Results: Of 117 patients, 54 had low intensity ITR3 scores (1 or2) and 63 had high intensity ITR3 scores (3 or 4). Mean distress score was 2.669 for the group. A weak but statistically significant association existed between ITR3 scores and distress scale scores (r = 0.2, n = 117, p = 0.022). Mean distress scale scores did not differ between men (2.26 +/- 2.09) and women (2.92 +/- 2.6) nor were they significantly related to age at diagnosis (p = 0.242). Needs assessment identified emotional, nutritional, and physical as the most frequent concerns. Care needs mostly commonly identified were feeling anxious/worried/irritable, being concerned with weight control, or problems with pain / fatigue. Conclusions: While we did not identify statistically significant differences in distress based on gender or age at diagnosis, we did find weak statistical association between higher treatment intensity and higher distress scores. Needs assessment helped guide care plan development. As childhood cancer survivor rates increase, we have an obligation to evolve our understanding of not only physical late effects but also psychological late effects.