• Carla I Ripamonti, Elena Bandieri, Maria Adelaide Pessi, Alice Maruelli, Loredana Buonaccorso, and Guido Miccinesi.
• Department of Hematology and Pediatric Onco-Hematology, Supportive Care in Cancer Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Via Venezian, 1, 20133, Milan, Italy, carla.ripamonti@istitutotumori.mi.it.
• Support Care Cancer. 2014 Mar 1;22(3):783-93.

BackgroundSymptoms' assessment should be considered a clinical practice routine in all cancer stages. The Edmonton Symptom Assessment System (ESAS) is a ten-item patient-rated symptom assessment developed and validated for population affected by cancer in different languages and cultures. The main objective of this study was to assess the performance of ESAS items on anxiety and depression when detecting Hospital Anxiety Depression Scale (HADS) 'cases'.MethodsA cross-sectional study was carried out on 194 non-advanced patients with solid (108) or hematologic malignancies on cure or follow up, Karnofsky Performance Status ≥ 70, life expectancy > 6 months and no metastases. Patients were assessed by means of ESAS and by HADS. Receiving operator characteristic (ROC) analysis of ESAS anxiety and depression items versus cases of severe (cutoff 11) anxiety and depression according to HADS-specific subscales was performed.ResultsDepression and anxiety ESAS items correlated strongly (0.707, Spearman). Area under the curve ranged between 0.84 and 0.96 for the two ESAS items when detecting severe anxiety or depression HADS cases (cutoff = 11). ESAS anxiety or depression scores >3 detected quite well the severe depression HADS cases (Sensibility = 75-Specificity = 84, Sensibility = 87-Specificity = 90, respectively).ConclusionsAnxiety or depression ESAS items score >3 can be applied as a useful, easy and not time consuming screening tool for assessing anxiety and depression in non-advanced patients with solid or haematological malignancies.

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