Prevalence and associated factors of psychological distress among patients with oral cancer in Sri Lanka

IntroductionOral cancer is the most common among Sri Lankan males leading to psychological distress due to its impact on the appearance and vital functions. While the negative effects of psychological distress on these patients are well known, its prevalence and associated factors remain largely unknown in Sri Lanka. This study aimed to assess the prevalence and the associated factors of psychological distress among a selected patient cohort with oral cancer in Sri Lanka. MethodsA hospital-based cross-sectional study was conducted among 355 patients with oral cancer to assess the prevalence of psychological distress. A nested case-control study among 140 (per arm) patients evaluated the associated factors for psychological distress. The multivariate analysis was carried out to identify significant factors associated with psychological distress. ResultsThe prevalence of psychological distress among patients with oral cancer was 31.0% (95% CI = 27.8%-35.3%). Being <50 years of age (Adjusted Odds Ratio (AOR)= 1.2, 95% CI= 0.7-1.7, p= 0.006), having pain (AOR (Adjusted Odds Ratio)= 44.7, 95% CI= 34-53.21, p=0.001), late stages of cancer at the diagnosis (AOR= 10.7, 95% CI= 1.07-28.78, p=0.04), being worried about basic functional disabilities (AOR= 11.4, 95% CI= 10.3-14.8, p=0.006) and the two psychological factors emerged as significant independent factors that were associated with increased risk of psychological distress among patients with oral cancer. ConclusionOne-third of patients with oral cancer in the selected tertiary care hospitals suffered from psychological distress indicating its high prevalence. Our findings on associated factors of psychological distress in patients with oral cancer have contributed to the development of an intervention strategy to reduce psychological distress in this population. O_LIWhat is already known on this topic - Psychological distress in patients with oral cancer negatively impacts the treatment outcomes and patients quality of life. However, the prevalence and associated factors of psychological distress in Sri Lankan patients with oral cancer are unknown. This lack of knowledge hinders efforts to improve treatment success and patient quality of life. C_LIO_LIWhat this study adds - Sri Lankan patients with oral cancer experience high rates of psychological distress, with several significant contributing factors C_LIO_LIHow this study might affect research, practice or policy - This study findings can guide a national program to identify and support Sri Lankan patients with oral cancer experiencing psychological distress, promoting early access to palliative care C_LI