There has been growing recognition in recent years that psychosocial care is an important component of the comprehensive care of people diagnosed with cancer. A notable example is the 2008 publication of an Institute of Medicine report titled, “Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs.”1 Among the report's main conclusions was that, despite evidence of the effectiveness of psychosocial services, many patients do not receive help for problems that would benefit from this type of care (eg, emotional and practical problems). To address this issue, the report recommended that standards for the quality of cancer care include the provision of appropriate psychosocial health services. Toward this end, the report outlined a model for the delivery of care in which processes are in place to identify patients' psychosocial health needs and link them with needed services.
These recommendations are predated in many ways by the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Distress Management first issued in 19992 and updated annually (available in this issue; to view the most recent version, visit NCCN.org).3 These guidelines were developed based on the recognized need for better management of distress and with the intent of promoting best practices for the psychosocial care of patients with cancer. The guidelines include standards of care for distress management and provide detailed recommendations in the form of clinical pathways about the evaluation and treatment of distress.
To evaluate the extent to which NCCN Member Institutions had implemented key aspects of these guidelines, the authors created and distributed a survey in 2005 to institutional representatives on the NCCN Distress Management Panel;4 results from that survey are summarized later in this report. With the growing recognition of the importance of psychosocial care, the authors were interested in learning whether member institutions had made progress in implementing the guidelines. Accordingly, they conducted a similar survey in 2012. The results of the new survey and comparisons with results of the 2005 survey are discussed.
Editor's Note: NCCN comprises 21 NCCN Member Institutions. For this survey, the authors counted 1 consortium cancer center as 2 institutions, resulting in 22 institutions.
Institute of Medicine. Cancer care for the whole patient: meeting psychosocial health needs. Washington: National Academies Press, 2008.
National Comprehensive Cancer Network. NCCN practice guidelines for the management of psychosocial distress. Oncology (Williston Park) 1999;13:113–47.
Holland JC, Andersen B, Breitbart WS. NCCN Clinical Practice Guidelines in Oncology for Distress Management. Version 2, 2013. Available at: NCCN.org. Accessed August 1, 2012.
Jacobsen PB, Ransom S. Implementation of NCCN distress management guidelines by member institutions. J Natl Comp Cancer Netw 2007;5:99–103.
Carlson LE, Waller A, Mitchell AJ. Screening for distress and unmet needs in patients with cancer: review and recommendations. J Clin Oncol 2012;30:1160–1177.
Roth AJ, Kornblith AB, Batel-Copel L. Rapid screening for psychologic distress in men with prostate cancer. Cancer 1998;82:1904–1908.
Commission on Cancer. Cancer program standards 2012: ensuring patient-centered care. Available at: http://www.facs.org/cancer/coc/cocprogramstandards2012.pdf. Accessed August 1, 2012.