LAUSR

654 Background: A cancer diagnosis can cause psychological distress that adversely affects patients’ emotional, social, spiritual and physical capabilities. The aim of this study is to identify factors associated with increased risk for psychosocial distress and to evaluate the influence of anxiety and depression on survival of GI cancer patients. Methods: All patients with GI cancer referred to BC Cancer from 2011-2015 who completed a prospective Psychosocial Screen for Cancer – Revised within 6 months of cancer diagnosis were included in the study. Baseline characteristics were collected from the BC Cancer registry. Patient groups were compared using the Chi-squared Fisher’s exact test. OS was calculated using the Kaplan Meier method, compared using the log rank test and Cox proportional hazards model. Results: 8722 patients were included in the analysis. Baseline characteristic: median age 67, male 60% , metastatic disease 29%. Colorectal/anal cancers (60%) were the most common followed by pancreatic cancer (11%). Patients with anxiety and depression were more likely to be younger (aged 64 and less), female and have metastatic disease. Patients with anxiety were more likely to get chemotherapy. Depression was associated with less chemotherapy use. Anxiety and depression were associated with increased psychosocial needs including emotional, informational, physical, spiritual, social/family concerns (p < 0.001). Psychological distress was not influenced by the patient’s geographic location or socioeconomic status. Median OS for patients with anxiety was 20 m vs no symptoms 27 m (p < 0.001) and depression 17 m vs no symptoms 27m (p < 0.001). The impact on OS remained significant for anxiety and depression in a multivariate model that included age, sex, metastatic status and chemotherapy use. Conclusions: Patients with GI malignancies who are female, younger than 64 and have metastatic disease are at risk for psychological distress. Anxiety and depression were associated with poorer survival outcomes even when controlling for age, sex, metastatic status and chemotherapy. Mobilizing resources to meet patients’ needs is important and should be implemented as part of patients’ comprehensive care.