AUA 2022: Prevalence and Predictors of Psychological Distress Among Patients Treated for Bladder Cancer

(  The 2022 Annual Meeting of the American Urological Association was host to a moderated poster session for non-invasive bladder cancer. Dr. Nihal Mohamed presented the results of her study evaluating the prevalence and predictors of psychological distress among patients treated for bladder cancer.


It has been well-established that bladder cancer diagnosis and treatment has a significant impact on patient quality of life (QoL). Increasing evidence from cancer research emphasize the importance of examining patients supportive care needs and social support as factors that could influence their emotional adjustment.

The aim of this study was to:

  • Assess the prevalence and demographic and clinical predictors of psychological distress among bladder cancer patients and its associations with patient reported supportive care needs and perceived availability of social support.

This was a cross-sectional analysis of bladder cancer patients recruited from the Bladder Cancer Advocacy Network (BCAN). Patients completed the following questionnaires: Hospital Anxiety and Depression Scale (HADS), bladder cancer patient need survey (BCNAS-32), and the social provisions scale (SPS). Included patients were English speakers, aged 18 to 85 years, and able/willing to provide informed consent. Exclusion criteria included metastatic disease, cancer recurrence or other primary cancers at time of evaluation.

This study included 159 patients. The mean age was 62±9.4 years and 51% were male.  About 37% reported cancer stage I, 25% reported cancer stage II, and 55% reported cancer stage III.  62% of patients underwent cystectomy and urinary diversion.


Patients reported elevated levels of psychological distress (Mean±SD:14.3±12.15) and this was significantly associated with younger age and lower educational levels (p for both < .05).


Both univariable and multivariable regression analyses revealed significant associations:

  • Psychological distress (HADS total score), HADS depression and anxiety subscales with patient age, physical functioning/daily living needs, sexuality needs, and perceived social support
  • Higher distress, anxiety, and depression scores with younger age, higher unmet needs, and lower levels of social support.

The authors concluded that bladder cancer patients experience significant psychological distress, and that these distress levels could be associated with increased patient supportive care needs and lack of social support. Patient quality of life and emotional adjustment could be improved with tailored, patient-focused interventions.

Presented by: Nihal Mohamed, PhD, Associate Professor of Psychology, Icahn School of Medicine at Mount Sinai, New York, NY

Written by: Rashid Sayyid, MD, MSc – Urology Chief Resident, Augusta University/Medical College of Georgia, @rksayyid on Twitter during the 2022 American Urological Association (AUA) Annual Meeting, New Orleans, LA, Fri, May 13 – Mon, May 16, 2022.