title: Effects of screening for psychological distress on patient outcomes in cancer: a systematic review.
abstract: OBJECTIVE
  Several practice guidelines recommend routine screening for psychological distress in cancer care. The objective was to evaluate the effect of screening cancer patients for psychological distress by assessing the (1) effectiveness of interventions to reduce distress among patients identified as distressed; and (2) effects of screening for distress on distress outcomes.
  
  
  METHODS
  CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO, and SCOPUS databases were searched through April 6, 2011 with manual searches of 45 relevant journals, reference list review, citation tracking of included articles, and trial registry reviews through June 30, 2012. Articles in any language on cancer patients were included if they (1) compared treatment for patients with psychological distress to placebo or usual care in a randomized controlled trial (RCT); or (2) assessed the effect of screening on psychological distress in a RCT.
  
  
  RESULTS
  There were 14 eligible RCTs for treatment of distress, and 1 RCT on the effects of screening on patient distress. Pharmacological, psychotherapy and collaborative care interventions generally reduced distress with small to moderate effects. One study investigated effects of screening for distress on psychological outcomes, and it found no improvement.
  
  
  CONCLUSIONS
  Treatment studies reported modest improvement in distress symptoms, but only a single eligible study was found on the effects of screening cancer patients for distress, and distress did not improve in screened patients versus those receiving usual care. Because of the lack of evidence of beneficial effects of screening cancer patients for distress, it is premature to recommend or mandate implementation of routine screening.
authors.affiliation: Interdisciplinary Center for Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Anna
authors.initials: A
authors.lastname: Meijer
authors.forename: Michelle
authors.initials: M
authors.lastname: Roseman
authors.forename: Vanessa C
authors.initials: VC
authors.lastname: Delisle
authors.forename: Katherine
authors.initials: K
authors.lastname: Milette
authors.forename: Brooke
authors.initials: B
authors.lastname: Levis
authors.forename: Achyuth
authors.initials: A
authors.lastname: Syamchandra
authors.forename: Michael E
authors.initials: ME
authors.lastname: Stefanek
authors.forename: Donna E
authors.initials: DE
authors.lastname: Stewart
authors.forename: Peter
authors.initials: P
authors.lastname: de Jonge
authors.forename: James C
authors.initials: JC
authors.lastname: Coyne
authors.forename: Brett D
authors.initials: BD
authors.lastname: Thombs
mesh_terms: D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications / Q000175:diagnosis* / Q000523:psychology