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01-10-2009 | Brief Communication | Uitgave 8/2009 Open Access

Quality of Life Research 8/2009

Prostate cancer-specific anxiety in Dutch patients on active surveillance: validation of the memorial anxiety scale for prostate cancer

Quality of Life Research > Uitgave 8/2009
Roderick C. N. van den Bergh, Ida J. Korfage, Gerard J. J. M. Borsboom, Ewout W. Steyerberg, Marie-Louise Essink-Bot



Men with prostate cancer (PC) may show specific disease-related anxiety. We evaluated the psychometric properties of the Dutch adaptation of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC).


The MAX-PC was translated using standardized forward–backward procedures. Patients (N = 150) on active surveillance, a strategy of initially withholding active therapy, for recently diagnosed early PC were mailed a questionnaire. Internal consistency was estimated using Cronbach’s alpha. The scale structure was analyzed using confirmatory factor analysis (CFA). Construct validity was evaluated by Pearson’s correlations between MAX-PC scores and scores on decisional conflict (DCS), generic anxiety (STAI), depression (CES-D), and general mental health (SF-12 MCS).


Data from 129 respondents were used (response rate 86%). Cronbach’s alpha for the total score and the three subscales were 0.77, 0.91, 0.64, and 0.85, respectively. CFA largely confirmed the three-factor structure as used in the original publication (model fit: χ2 149, P = 0.051). The patterns of directions and sizes of the correlations (r = 0.36–0.66) between MAX-PC scale scores and the other variables were in accordance with a priori hypotheses, except for the prostate-specific antigen anxiety subscale. The relatively poor performance of this scale in the original version was replicated.


The structure and validity of the MAX-PC to quantify PC-specific anxiety were largely confirmed in Dutch patients.

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