"We have been using the CSS distress screener and recently used it for a  caregiver study. PPS was wonderful to work with as we customized the tool so we could add some COVID-19 specific questions. Customization was quick and seamless.  Having access to the raw data and being able to provide support to patients and caregivers in real time has been so helpful for patient experience and satisfaction metrics."  

Allison Applebaum, Ph.D.​

Assistant Attending Psychologist and Director,

Caregivers Clinic, at Memorial Sloan Kettering Cancer Center - 

CancerSupportSource® (CSS) is the first comprehensive cancer distress screening program developed for community-based hospitals, physician practices and advocacy organizations to integrate screening, referral and follow-up care, through a single, streamlined, program.

Routine screening for social and emotional distress is a key component to comprehensive quality cancer care and is a recommendation of the 2008 Institute of Medicine’s Report, Cancer Care for the Whole Patient, Meeting Psychosocial Health Needs and also the new patient-centered standards from the American College of Surgeon’s Commission on Cancer which state that beginning in 2015, all cancer patients must be screened for distress if seen in an accredited cancer center.

CancerSupportSource® helps cancer centers meet those critical standards easily and effectively. CancerSupportSource® is more than a distress screening tool—it enables health care providers to create a vital program linking patient-reported needs with in-house and community support services.

CancerSupportSource® provides compliance with the Commission on Cancer requirement 5.2 as well as is an approved depression screener for the Oncology Care Model (OCM).


  • 2-year retrospective study of breast cancer patients at Orlando Health Cancer Support Community showed the following results as presented at NCCN March 2020 Conference.

  • The number of hospitalized days was 50% higher for patients who had not been screened with the Cancer Support Community CancerSupportSource® distress screener.

  • Patients screened with the CSS distress screener had fewer emergency room visits.

  • Distress Screening using CancerSupportSource® may affect health care cost utilization.

Barriers to Care (distress & depression) & how CANCERSUPPORTSOURCE® CSS can help.

  • In our latest research, 43 percent of cancer patients who used the tool were at risk for significant anxiety, and 34 percent were at risk for significant depression. (2018, Cancer Experience Registry Study, CSC RTI).

  • Identifying patients at risk for depression is cost saving.  The CancerSupportSource® (CSS) is the only oncology specific tool that has scientifically validated subscales built in to identify patients at high risk for clinical depression and anxiety and has shown to decrease false positives.

  • A study of 13,233 cancer patients indicates that depressed cancer patients incur significantly higher health care charges across multiple cost categories including ambulatory care, emergency, department and hospital visits.  Depressed cancer patients had total annual health care charges that were 113% higher than nondepressed cancer patients. The estimated mean charges for depressed patients were $235 337 compared with $110 650 for nondepressed patients.(Psychooncology. 2018 Jul;27(7):1735-1741. doi: 10.1002/pon.4716. Epub 2018 Apr 25. Health care costs of depression in patients diagnosed with cancer. Mausbach BT1,2, Yeung P3, Bos T4, Irwin SA5.)

  • A recent study found that adhering to depression screening protocols reduced Emergency Department visits and hospitalizations by 18%. Zebrack B. Kayser K. Bybee D. et. Al. A Practice-Based Evaluation of Distress Screening Protocol Adherence and Medical Service Utilization. J. Ntl. Compr. Cancer Netw. 2017; 15: 903-12


  • Provides a real time clinical snapshot that allows treatment team ability to provide more precise feedback and treatment planning driven by patient reported outcomes that translates into higher patient satisfaction metrics.

  • Provides increased screening efficiency and streamlining with automation for the care team.

  • Provides ability to identify specific stressors including risk for depression & anxiety in patients. Tool provides automation of  distress screening process resulting in fewer inconsistencies across multiple care locations.

  • Provides visibility into patient experience and status of patient stress over the course of treatment.

  • Provides accessibility of records historically and across locations to track trends & population health.

  • Provides better time management, decrease in staffing burdens and allows for more patient-facing time. This decreases time of sessions/visits allowing more patients to be seen.

  • Using sophisticated mathematical analyses such as factor analysis, we confirmed that CSS examines distress in key areas of people’s lives, including; emotional concerns, symptom burden and impact, body and healthy lifestyle concerns, health care communication, and relationship concerns.


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