Measurement of distress and its alteration during treatment in patients with nasopharyngeal carcinoma

Background We examined the criterion‐related validity of the Distress Thermometer (DT) for screening distress in patients with nasopharyngeal carcinoma (NPC) and investigated prospectively how distress changes. Methods In the cross‐sectional study, the DT was tested against the Hospital Anxiety and Depression Scale (HADS) in 295 patients with NPC. In the prospective study, 61 newly diagnosed patients with NPC completed the DT and HADS 6 times. Results Adopting HADS as the standard tool for screening distress, 31.5% of the patients with NPC had distress. A DT cutoff score ≥4 had best sensitivity (0.73) and specificity (0.85). In the prospective study, the proportion of patients with distress rose significantly during treatment. Conclusion Receiver operating characteristic (ROC) findings provide initial support for the validity of the DT among patients with NPC. Nearly one third of patients with NPC exceeded cutoff values for distress in the cross‐sectional study. In the prospective study, the level of distress increased significantly during concurrent chemoradiotherapy for patients with NPC. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1077–1086, 2014