Psychosocial Distress Screening Guidelines


Failure to identify and treat symptoms reduces quality of life.

As part of the process of publishing clinical practice guidelines on survivorship topics, the American Society of Clinical Oncology (ASCO) convened a panel of experts to review and adapt the Pan-Canadian Guideline on Screening, Assessment, and Care of Psychosocial Distress (Depression, Anxiety) in Patients with Cancer. Using procedures set forth by ASCO for adapting clinical practice guidelines developed by other organizations, the guideline was reviewed for developmental rigor and content applicability.

The ASCO panel found that the recommendations were clear, thorough, and based on the most relevant scientific evidence. However, for some topics addressed in the pan-Canadian guideline, the ASCO panel formulated a set of adapted recommendations based on local context and practice beliefs of the ad hoc panel members. The panel recommended that all patients with cancer are evaluated for symptoms of depression and anxiety at periodic times across the trajectory of care. Screening for depression may be as simple as inquiring about lack of interest or pleasure in doing thing and feeling down, depressed, or helpless. The panel developed an algorithm for responding to high depression scores. Similarly, anxiety should be repeatedly assessed and an algorithm lists possible interventions, including psychological (focusing on the individual), pharmacological, psychosocial (focusing on group intervention). The panel concluded that failure to identify and treat these symptoms may lead to a decreased quality of life for patients with cancer.


Anderson BL, DeRubeis RJ, Berman BS, et al. Screening, Assessment, and Care of Anxiety and Depressive Symptoms in Adults with Cancer: An American Society of Clinical Oncology Guideline Adaptation. J Clin Oncol, published online before print April 14, 2014, doi: 10.1200/JCO.2013.52.4611.

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