The functional assessment of cancer therapy scale: Development and validation of the general measure

David F. Cella, David S. Tulsky, George Gray, Bernie Sarafian, Elizabeth Linn, Amy Bonomi, Margaret Silberman, Suzanne B. Yellen, Patsy Winicour, Judy Brannon, Karen Eckberg, Stephen Lloyd, Sandy Purl, Carol Blendowski, Michelle Goodman, Madeline Barnicle, Irene Stewart, Marnie McHale, Philip Bonomi, Edward KaplanSamuel Taylor IV, Charles R. Thomas, Jules Harris

Research output: Contribution to journalArticlepeer-review

4561 Scopus citations


Purpose: We developed and validated a brief, yet sensitive, 33-item general cancer quality-of-life (QL) measure for evaluating patients receiving cancer treatment, called the Functional Assessment of Cancer Therapy (FACT) scale. Methods and Results: The five-phase validation process involved 854 patients with cancer and 15 oncology specialists. The initial pool of 370 overlapping items for breast, lung, and colorectal cancer was generated by open-ended interview with patients experienced with the symptoms of cancer and oncology professionals. Using preselected criteria, items were reduced to a 38-item general version. Factor and scaling analyses of these 38 items on 545 patients with mixed cancer diagnoses resulted in the 28-item FACT-general (FACT-G, version 2). In addition to a total score, this version produces subscale scores for physical, functional, social, and emotional well-being, as well as satisfaction with the treatment relationship. Coefficients of reliability and validity were uniformly high. The scale's ability to discriminate patients on the basis of stage of disease, performance status rating (PSR), and hospitalization status supports its sensitivity. It has also demonstrated sensitivity to change over time. Finally, the validity of measuring separate areas, or dimensions, of QL was supported by the differential responsiveness of subscales when applied to groups known to differ along the dimensions of physical, functional, social, and emotional well-being. Conclusion: The FACT-G meets or exceeds all requirements for use in oncology clinical trials, including ease of administration, brevity, reliability, validity, and responsiveness to clinical change. Selecting it for a clinical trial adds the capability to assess the relative weight of various aspects of QL from the patient's perspective.

Original languageEnglish (US)
Pages (from-to)570-579
Number of pages10
JournalJournal of Clinical Oncology
Issue number3
StatePublished - 1993
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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