Psychological distress affects a substantial share of patients with cancer, even where supportive care services are in place, according to a retrospective analysis of 21,206 oncology patients at UT Southwestern Medical Center being presented at the 2026 American Nurses Enterprise (ANE) Research Symposium in Chicago.1,2 Drawing on electronic medical record and tumor registry data from 2023 to 2025, investigators found that 26.4% of patients met the screening threshold for anxiety and 35.8% for depressed mood.1 In an interview with Oncology Nursing News, lead investigator Yingzi Zhang, PhD, RN, discussed the findings and what they mean for daily nursing assessment.
What was the most critical finding, and how should it shape nursing assessments?
We used [data] across different clinics at UT Southwestern over the past 2 years, from 2023 to 2025. There are a couple of important messages I want to share. First, there is a substantial proportion of patients experiencing anxiety and depression symptoms, which is very alarming to me. [About] 1 in 4 patients met the GAD-7 [threshold] for anxiety, with a threshold of 5, and more than 1 in 3 patients experienced depressed mood measured by the PHQ-9 with a threshold of 5. That is a really large [proportion] of patients who experience psychological [distress].
So I want nurses to know that the psychosocial experience is part of our cancer care. We are not just dealing with physical symptoms. We are not just dealing with removing the tumor for [patients]. We are also dealing with the psychosocial aspect of cancer care. I think oncology nurses—and my background is in oncology nursing as well—have a really good understanding of the psychosocial aspect of the cancer experience. But even though we implement a lot of supportive care services, we still have a large number of patients who experience anxiety and depression.
Of course, we want to do all good things with good intention. The problem I’ve noticed in my practice and in my research is access. A lot of times we are building a lot of supportive care services, and we do referrals, of course, if [patients] meet the threshold, but not a lot of people go get the service. So maybe access is an issue. I’m not sure, because it was not examined in this study.
Another interesting thing I want to point out is that from our study, we identified a lot of associated factors, such as the primary language [patients] spoke, age, marital status, employment, education, and smoking history, and those are associated with different outcomes. These findings encourage us as nurses to ask people about their social background. This can be an opening for an individualized conversation: What troubles you? What support do you have at home? Do you need any help? Things like that, when we have an encounter with our patients.
One important thing I want to say is that demographic characteristics alone [don’t] tell us what support the patient needs, but they may point [to] a question for us to explore. That’s the message I want to deliver to the nurses who review my poster.
How can nurses close the gap between high distress and low support service uptake?
Screening is definitely the first step. This is what we do at UT Southwestern: We screen all the patients who walk in the door. We have the NCCN [Distress Thermometer] implemented throughout the comprehensive cancer center, but we don’t know if other cancer [centers] have that implemented. I don’t have the data to show you that all the patients got that. So screening is definitely step one.