Objectives: An estimated 20-60% of head and neck cancer patients have reported distress during the evaluation and management of their disease. This study aims to assess for a relationship between distress scores and several perioperative metrics. Design: Retrospective cohort study Setting: Single tertiary care center Main Outcome Measures: 34 head and neck cancer patients during the designated time period were evaluated for their distress screening results. Primary outcomes evaluated are distress scores, stratified by age and subsite, as well as, staging. Power analysis and logistic regression were performed. Results: Significantly lower distress scores were associated with a skin primary site (OR = 0.06, 0.003-0.41 95% CI, p = 0.01<0.05), and there was a trend toward lower distress score with Medicare insurance (OR=0.11, 0.01-0.76 95% CI, p=0.06>0.05) indicating potential protective factors against distress scores >3. Conclusions: Identifying specific protective factors may objectively help identify new head and neck cancer patients who are at higher risk for greater levels of distress.