FACT-Ovarian: Functional Assessment of Cancer Therapy—Ovarian
Functional Assessment of Cancer Therapy—Ovarian · Also known as: FACT-O
The FACT-Ovarian (FACT-O) is a disease-specific quality-of-life measure for women with ovarian cancer, integrating the 27-item FACT-G core with a 12-item ovarian-specific subscale addressing cancer-related symptoms, sexual function, abdominal distension, and treatment side effects. Validated by Basen-Engquist et al. in 2001, it is a standard endpoint in ovarian cancer clinical trials and supportive care research.
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When to use it
FACT-Ovarian is indicated for women with epithelial ovarian cancer (including fallopian tube and primary peritoneal cancers), any stage, undergoing surgery, platinum-based chemotherapy, targeted therapy (PARP inhibitors, bevacizumab), or surveillance. Primary use is clinical trials assessing treatment efficacy and patient-reported outcomes; secondary use in oncology clinic monitoring (baseline, q3–6 months during active treatment, post-treatment surveillance). NOT for screening or diagnosis. Particularly valuable when treatment decisions involve symptom burden vs. survival trade-offs (e.g., dose intensity of chemotherapy, maintenance therapy decisions, palliative care timing).
Strengths & limitations
- Ovarian-cancer-specific subscale directly measures gastrointestinal symptoms, abdominal distension, and sexual function—critical domains in ovarian cancer QoL not captured by generic scales.
- Validated in large, diverse ovarian cancer cohorts (stages I–IV, first-line and recurrent disease, various chemotherapy regimens); strong psychometric properties.
- Public domain, no licensing cost; freely available in multiple languages and modalities.
- Widely adopted in major ovarian cancer trials (GOG, SWOG, ECOG, EORTC, international cooperative groups); high regulatory credibility.
- Enables distinction between general cancer burden and ovarian-specific symptom impact; supports targeted symptom management and clinical decision support.
- OCS subscale (12 items) may lack granularity for distinguishing specific GI symptoms (nausea vs. constipation vs. diarrhea) or detailed sexual dysfunction phenotyping.
- FACT-G core assumes general cancer relevance; some items may be less salient for early-stage patients in surveillance.
- Limited validation in non-epithelial ovarian cancers (germ cell, sex cord-stromal) or metastatic disease from non-ovarian primaries.
- Ceiling effects in early-stage, disease-free patients; may not detect subtle improvements in asymptomatic surveillance.
Frequently asked
Can FACT-O be used in patients with recurrent or platinum-resistant ovarian cancer?
Yes. FACT-O is validated across ovarian cancer stages and disease status (first-line, recurrent, platinum-resistant). Recurrent/resistant patients typically have lower baseline FACT-O scores reflecting higher disease burden and treatment history. Interpretation should account for treatment context; change scores are often more clinically meaningful than absolute scores in progressing disease.
How does FACT-O compare to EORTC QLQ-OV28?
FACT-O (39 items: 27 FACT-G + 12 OCS) has a broader general cancer QoL core plus ovarian-specific extension. EORTC QLQ-OV28 (28 ovarian-specific items added to QLQ-C30 core) emphasizes detailed symptom and functional scales (abdominal/GI symptoms, peripheral neuropathy, sexual function). FACT-O more prevalent in North America; EORTC more common in Europe. Both valid; choice depends on trial coordination and regional practice.
What is the MCID for FACT-O total and OCS, and how is it applied?
MCID for FACT-O total is approximately 10–12 points; for OCS subscale, 4–6 points. These represent the smallest change a patient would notice as clinically meaningful. In trials, MCID helps determine clinical significance of treatment effects. In clinic, serial FACT-O changes (baseline to follow-up) of ≥MCID suggest meaningful QoL change warrant clinical intervention (e.g., symptom management intensification, treatment modification).
Is FACT-O appropriate for early-stage ovarian cancer patients on surveillance?
Yes. FACT-O is validated across all ovarian cancer stages, including early-stage (I–II) patients in surveillance. Early-stage patients typically have higher (better) FACT-O scores than advanced-disease patients. Longitudinal FACT-O tracking can assess anxiety, late toxicities, and any QoL changes; ceiling effects may limit sensitivity to minor improvements in already-high-scoring patients.
How are missing data handled in FACT-O scoring?
If ≥50% of subscale items are missing, do not score that subscale. If <50% are missing, impute the mean of completed items and multiply by the full subscale item count. Report number of missing items when presenting results. Avoid interpretation if data quality is poor (e.g., >2 missing items in any subscale).
Is FACT-O available in multiple languages and without cost?
Yes. FACT-O is public domain (free, no licensing fees). Official versions and validated translations in 20+ languages are available via FACIT.org (www.facit.org) and directly from developers. Use official versions to ensure psychometric validity; modified or informal translations are not recommended.
Sources
- Basen-Engquist, K., Bodurka, D. C., Lu, H., Sill, M. W., Thaker, P. H., Deavers, M. T., et al. (2001). Reliability and validity of the Functional Assessment of Cancer Therapy-Ovarian (FACT-O) quality of life instrument. Gynecol Oncol, 89(3), 478–488. DOI: 10.1200/jco.2001.19.6.1809 ↗
- Cella, D. F., Tulsky, D. S., Gray, G., Sarafian, B., Linn, E., Bonomi, A., et al. (1993). The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol, 11(3), 570–579. DOI: 10.1200/JCO.1993.11.3.570 ↗
How to cite this page
ScholarGate. (2026, June 3). Functional Assessment of Cancer Therapy—Ovarian. ScholarGate. https://scholargate.app/en/oncology/fact-ovarian
Which method?
Set this method beside its closest kin and read them side by side — the library lays the books on the table; the choice is yours.
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