Translation and validation of the Chinese version of the adolescent and young adult psycho-oncology screening tool

Objective: Adolescents and young adults (AYAs) with cancer suffer from a high prevalence of psychological distress, but validated, age-appropriate screening tools remain limited in China. The study aimed to translate and validate a Chinese version of the Adolescent and Young Adult Psycho-Oncology Screening Tool (AYA-POST). Methods: A methodological study was conducted, including forward and back translation, expert consultation, and a pilot testing. AYAs with cancer (n ​= ​301; 15–39 years at diagnosis; M_age ​= ​34.00 ± 5.99 years) across two hospitals in China from September 2024 to April 2025 were included. Measures included sociodemographic, clinical data, the AYA-POST (comprising the Distress Thermometer [DT] and AYA Needs Assessment [AYA-NA]), and the Hospital Anxiety and Depression Scale (HADS). Results: All content validity indices were 1.0. Exploratory factor analysis yielded a four-factor solution explained 35% of the total variance, with a mean item complexity of 1.89. The DT correlated strongly with the HADS (r ​= ​0.533, P ​< ​0.001). A DT cut-off score of 4 showed optimal sensitivity (0.774; area under the curve ​= ​0.736). Cronbach's α was 0.754 for AYA-POST and ranged from 0.315 to 0.704 at domain level. The prevalence of psychological distress was 57.14% with a cut-off score of 4. The most frequent concerns were physical (83.72%), emotional (73.42%), and practical (66.78%). Conclusions: The Chinese version of the AYA-POST demonstrated acceptable validity and reliability in AYAs with cancer. It can be a tool for stratified distress and psychosocial concerns management, with a DT cut-off score of 4 recommended for initial screening.