Prevalence and Predictors of Death-Related Distress Among Cancer Patients in a Multi-Ethnic Asian Setting: A Cross-Sectional Study

This study examined the prevalence, pattern, and predictors of death-related distress among 156 cancer patients in a multi-ethnic Malaysian setting. The main concerns related to the dying process and its consequences, particularly prolonged dying, becoming a burden to others, the impact of death on loved ones, and unfinished life goals. Moderate-or-greater distress affected 39% of patients for prolonged dying and approximately one-third for the other major concerns. Multivariable analysis showed that greater death-related distress was independently associated with younger age, mild functional decline reflected by ECOG performance status 1, higher anxiety, and greater suffering. These factors collectively explained a substantial proportion of variation in distress scores. The findings indicate that death-related distress is common among cancer patients and may not be limited to those with advanced physical impairment. Routine screening should therefore focus particularly on younger patients, those showing early functional deterioration, and individuals experiencing significant anxiety or global suffering.