Establishing the sensitivity and specificity of the gynaecological cancer distress screen

Psychooncology. 2024 Mar;33(3):e6328. doi: 10.1002/pon.6328.

Abstract

Objective: Nuanced distress screening tools can help cancer care services manage specific cancer groups' concerns more efficiently. This study examines the sensitivity and specificity of a tool specifically for women with gynaecological cancers (called the Gynaecological Cancer Distress Screen or DT-Gyn).

Methods: This paper presents cross-sectional data from individuals recently treated for gynaecological cancer recruited through Australian cancer care services, partner organisations, and support/advocacy services. Receiver operating characteristics analyses were used to evaluate the diagnostic accuracy of the DT-Gyn against criterion measures for anxiety (GAD-7), depression (patient health questionnaire), and distress (IES-R and K10).

Results: Overall, 373 individuals aged 19-91 provided complete data for the study. Using the recognised distress thermometer (DT) cut-off of 4, 47% of participants were classified as distressed, while a cut-off of 5 suggested that 40% had clinically relevant distress. The DT-Gyn showed good discriminant ability across all measures (IES-R: area under the curve (AUC) = 0.86, 95% CI = 0.82-0.90; GAD-7: AUC = 0.89, 95% CI = 0.85-0.93; K10: AUC = 0.88, 95% CI = 0.85-0.92; PHQ-9: AUC = 0.85, 95% CI = 0.81-0.89) and the Youden Index suggested an optimum DT cut-point of 5.

Conclusions: This study established the psychometric properties of the DT-Gyn, a tool designed to identify and manage the common sources of distress in women with gynaecological cancers. We suggest a DT cut point ≥5 is optimal in detecting 'clinically relevant' distress, anxiety, and depression in this population.

Keywords: cancer; distress thermometer; gynaecological cancer; oncology; psycho-oncology; psychological support; routine screening; sensitivity; specificity.

MeSH terms

  • Anxiety / diagnosis
  • Anxiety / epidemiology
  • Australia
  • Cross-Sectional Studies
  • Depression / diagnosis
  • Depression / epidemiology
  • Female
  • Genital Neoplasms, Female* / diagnosis
  • Humans
  • Mass Screening
  • Neoplasms* / epidemiology
  • Psychometrics
  • Sensitivity and Specificity
  • Stress, Psychological / diagnosis
  • Stress, Psychological / epidemiology
  • Surveys and Questionnaires

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