gms | German Medical Science

Aims: The NCCN Distress-Thermometer is a brief screening tool for cancer patients to assess distress. It has been developed by the National Comprehensive Cancer Network (NCCN) in the US. It consists of a scale from 0-10 and a problem list which provides information to which health care professionals a patient should be referred. A score of 5 is internationally recommended as an indicator that a patient is distressed and needs support.

Methods: For the German adaptation, a sample of n=475 cancer patients was assessed during oncological rehabilitation. To validate the screening tool, we used the Hospital Anxiety and Depression Scale (HADS-D) and the brief version of the Fear of Progression Questionnaire (PA-F 12).

Results: The discriminating power of the Distress-Thermometer was particularly good when screening for higher levels of anxiety or/and depression (HADS Cut-off > 11): AUC from 0.71 to 0.76. For a score of 5 in the Distress-Thermometer, we found a sensitivity up to 84% and a lower specifity up to 47% when screening for moderate levels of anxiety or/and depression (HADS Cut-off > 8). Screening for a higher level of distress (HADS Cut-off > 11), we found a sensitivity up to 97% and a specifity up to 41% when using a score of 5 in the Distress-Thermometer. The specifity of the instrument is lower as the values for specifity found in international studies, but the sensitivity is little higher in the German sample.

Conclusions: Due to its high acceptance, its brevity and practice orientation, the NCCN Distress-Thermometer can be recommended as a screening tool to assess psychosocial distress in cancer patients.