OBJECTIVES: We describe the completion of the National Comprehensive Care Network's distress thermometer (DT) survey for multiple myeloma (MM), quantify, and identify factors influencing distress score. METHODS: We assessed DT completion for MM patients' first consultation at an academic center between January 1, 2015, and December 31, 2022. Multivariate logistic regression was conducted to identify factors associated with survey completion and distress. RESULTS: Of 1011 new patients, 683 (68%) completed the DT survey. Noncompletion at initial consultation was associated with non-Hispanic Black patients [AOR 0.50 (95% CI 0.32-0.79), p = 0.003], socially vulnerable neighborhood residence [AOR 0.54 (95% CI 0.39-0.76), p = 0.0004], Karnofsky Performance Status <
90 [AOR 0.60 (95% CI 0.43-0.86), p = 0.005], and recent years of consult [AOR 0.38, (95% CI 0.28-0.52), p <
0.0001]. Nonrespondents were less likely to receive a subsequent autologous stem cell transplantation (71% vs. 79%, p <
0.01). The median distress score among respondents was 3% with 22% reporting 0 distress. Distress was associated with female sex [AOR 1.48, (95% CI 1.07-2.04), p = 0.017] and stage [stage 2 vs. stage 1, AOR 1.76 (95% CI 1.20-2.57), p = 0.004]. CONCLUSIONS: Disparities in nonrespondents of the DT survey at initial consultation suggest the limitations of relying on the screening tool to assess unmet needs among high-risk patients.