European Archives of Oto-Rhino-Laryngology

, Volume 274, Issue 5, pp 2253–2260 | Cite as

Screening for distress using the distress thermometer and the University of Washington Quality of Life in post-treatment head and neck cancer survivors

  • Naseem GhazaliEmail author
  • Brenda Roe
  • Derek Lowe
  • Sank Tandon
  • Terry Jones
  • James Brown
  • Richard Shaw
  • Janet Risk
  • Simon N. Rogers
Head and Neck


The primary aim was to determine the efficacy of the Distress Thermometer (DT) in screening for anxiety and mood problems against the University of Washington Quality of Life, version 4 (UWQOL). Secondary aims were to evaluate the association between demographic, clinical and health-related QOL variables with significant distress. Two hundred and sixty one disease-free HNC ambulatory patients attending routine follow-up clinics were prospectively recruited. Both DT and UWQOL were completed pre-consultation. Receiver operating characteristic (ROC) curve analyses of DT score for anxiety dysfunction yielded an area under the curve (AUC) of 0.877, with a sensitivity of 84% (43/51) and specificity of 76% (159/210) for a DT cut-off of ≥4; with a corresponding AUC of 0.825 for mood with sensitivity 78% (28/36) and specificity 71% (159/225). Treatment with radiotherapy and a longer consultation time were associated with significant distress (DT ≥4). Significant distress was also reported in two third of those reporting less than “Good” overall QOL. Distress levels were particularly associated with poor Social–Emotional function, more so than the association seen with poor physical function. DT is a reasonable screening tool for distress in the HNC population. The DT cut-off score ≥4 was effective in identifying those with significant distress. Significant distress is associated in survivors with poor health-related quality of life, those who received radiotherapy and patients who have longer consultation times in clinic.


Distress Head and neck cancer University of Washington Quality of Life Distress thermometer Screening 


Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to declare.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Molecular and Clinical Cancer Medicine, Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
  2. 2.Regional Maxillofacial UnitAintree University Hospitals NHS TrustLiverpoolUK
  3. 3.Faculty of Health and Social Care, Evidence-Based Practice Research CentreEdge Hill UniversityOrmskirkUK
  4. 4.ENT UnitAintree University Hospitals NHS TrustLiverpoolUK

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