title: The psychosocial screen for cancer (PSSCAN): further validation and normative data.
abstract: BACKGROUND
  We have previously reported on the development of a cancer-specific screening instrument for anxiety and depression (PSSCAN). No information on cut-off scores or their meaning for diagnosis was available when PSSCAN was first described. Needed were additional analyses to recommend empirically justified cut-off scores as well as data norms for healthy adult samples so as to lend meaning to the recommended cut-off scores.
  
  
  METHODS
  We computed sensitivity/specificity indices based on a sample of 101 cancer patients who had provided PSSCAN data on anxiety and depression and who had completed another standardized instrument with strong psychometrics. Next, we compared mean scores for four samples with known differences in health status, a healthy community sample (n = 561), a sample of patients with a representative mix of cancer subtypes (n = 570), a more severely ill sample of in-patients with cancer (n = 78), and a community sample with a chronic illness other than cancer (n = 85).
  
  
  RESULTS
  Sensitivity/specificity analyses revealed that an excellent balance of sensitivity/specificity was achievable with 92%/98% respectively for clinical anxiety and 100% and 86% respectively for clinical depression. Newly diagnosed patients with cancer were no more anxious than healthy community controls but showed elevations in depression scores. Both, patients with chronic illness other than cancer and those with longer-standing cancer diagnoses revealed greater levels of distress than newly diagnosed cancer patients or healthy adult controls.
  
  
  CONCLUSIONS
  These additional data on criterion validity and community versus patient norms for PSSCAN serve to enhance its utility for clinical practice.
authors.affiliation: Department of Psychology, University of British Columbia, Vancouver, BC, Canada. wlinden@psych.ubc.ca
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Linden
authors.forename: A
authors.initials: A
authors.lastname: Andrea Vodermaier
authors.forename: Regina
authors.initials: R
authors.lastname: McKenzie
authors.forename: Maria C
authors.initials: MC
authors.lastname: Barroetavena
authors.forename: Dahyun
authors.initials: D
authors.lastname: Yi
authors.forename: Richard
authors.initials: R
authors.lastname: Doll
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis*; D019540:Area Under Curve; D003863:Depression / Q000175:diagnosis; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires