Gender disparities in extreme psychological distress at cancer diagnosis and patients access to psycho-oncological care.

Abstract

Background: Cancer has adverse consequences for mental health, especially in women. Lack of awareness of services and stigma diminish access to psycho-oncology services.

Aims: To assess psychological distress and willingness to engage in multidisciplinary psycho-oncological services among cancer patients.

Methods: Cross-sectional survey of attitudes towards psycho-oncology services in 142 cancer patients.

Results: Women experienced more extreme distress than men, with 46.4% of females and 17.8% of males reporting "extreme" distress. Under one third of cancer patients (30.3%) knew the meaning of 'psycho-oncology'; one quarter (25.6%) knew of the psycho-oncology service, and two thirds (67.2%) were unsure if referral would be beneficial. One fifth (21.0%) would be somewhat/extremely uncomfortable disclosing attending palliative care, compared to 17.9% for psychiatry, 14.4% for psychology, and 5.8% for cardiology. On multivariable analysis, pre-existing psychiatric/psychological difficulty was the only variable independently associated with belief that a psycho-oncology referral would be beneficial.

Conclusions: Limited awareness of psycho-oncology services exist despite high rates of extreme distress among women with cancer.. Given that women have higher levels of extreme distress, it would be prudent to offer them enhanced psycho-oncological care.