Self-reported distress and problems after treatment for gynecological cancer - Correlation between a short screening tool and longer measures of anxiety/depression and health-related quality of life

IntroductionThe National Comprehensive Cancer Network (NCCN) distress thermometer and problem list (DTPL) is a brief self-report screening measure for use in follow-up cancer care. The aims of this study were to explore the correlations between scores on the DTPL and scores on longer measures of anxiety/depression and health-related quality of life among women treated for gynecological cancer, and to define a cutoff score on the DT representing high levels of psychological distress in this patient group.Material and methodsDuring outpatient visits, 144 women filled in the DTPL, the Hospital Anxiety and Depression Scale (HADS) and the RAND-36-Item Short Form Health Survey (RAND-36) between October 2019 and March 2020. We assessed the agreement between the DT-scores and the HADS scores, explored variables associated with high levels of distress on the DT, and studied the associations between DTPL-scores and scores of health-related quality of life (HRQoL) from RAND-36.ResultsIn receiver operating characteristic curve analysis between the distress score from the DT and a HADS total score >= 15 (defining high levels of anxiety/depression symptoms), the area under the curve was 0.81 (95% CI: 0.74-0.89). Using a cutoff of >= 5 on the DT (scale 0-10), we found a balanced level of sensitivity (81%) and specificity (71%) towards a HADS total score of >= 15. The scores of distress and problems reported on the DTPL correlated significantly with the majority of HRQoL function scales from RAND-36.ConclusionsThe NCCN DTPL can be used as a screening measure for self-reported distress and problems after treatment for gynecological cancer. A score of >= 5 on DT may indicate high level of anxiety/depression as measured by HADS. The tool may help identify patients in need of referral to supportive care and rehabilitation facilities. The scores on the brief Distress Thermometer (DT) and Problem List showed high correlations with scores of anxiety/depression and health related quality of life among gynaecological cancer patients. A DT-score of >= 5 (range 0-10) indicate high level of psychological distress.image