Patient‐reported distress and age‐related stress biomarkers among colorectal cancer patients

Objective Distress among cancer patients has been broadly accepted as an important indicator of well‐being but has not been well studied. We investigated patient characteristics associated with high distress levels as well as correlations among measures of patient‐reported distress and “objective” stress‐related biomarkers among colorectal cancer patients. Methods In total, 238 patients with colon or rectal cancer completed surveys including the Distress Thermometer, Problem List, and the Hospital Anxiety and Depression Scale. We abstracted demographic and clinical information from patient charts and determined salivary cortisol level and imaging‐based sarcopenia. We evaluated associations between patient characteristics (demographics, clinical factors, and psychosocial and physical measures) and three outcomes (patient‐reported distress, cortisol, and sarcopenia) with Spearman's rank correlations and multivariable linear regression. The potential moderating effect of age was separately investigated by including an interaction term in the regression models. Results Patient‐reported distress was associated with gender (median: women 5.0, men 3.0, p
Patient‐reported distress is closely associated with psychosocial and physical needs experienced by colorectal cancer patients, while cortisol is limited in its association to certain needs and younger patients. Stress biomarkers may not be as reliable as patient‐reported distress in understanding the colorectal patient experience.