# FACT-G and the FACIT family: the other main questionnaire

Source: https://onco.cc/technologies/rejuv-measure-fact-and-facit/  
OnCo record `rejuv-measure-fact-and-facit` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Twenty-seven questions about the past week, in four areas: the body, family and friends, feelings, and being able to do ordinary things. Dozens of add-ons exist for particular cancers and particular symptoms, including the fatigue scale used in most anaemia and fatigue trials.

## Summary

The Functional Assessment of Cancer Therapy general scale was developed from open-ended interviews with patients and oncology professionals and validated across five phases involving 854 people with cancer and 15 oncology specialists. The 1993 paper describes the resulting instrument as producing "subscale scores for physical, functional, social, and emotional well-being, as well as satisfaction with the treatment relationship". The version in use now, FACT-G version 4, has 27 items in four subscales, physical, social and family, emotional and functional well-being, with a recall period the publisher gives as "Past 7 days" and a completion time it gives as "5-10 minutes".

The family is the reason it matters. FACIT, the Functional Assessment of Chronic Illness Therapy system, built the core scale out into a library: disease-specific versions (FACT-B for breast, FACT-C for colorectal, FACT-L for lung, FACT-P for prostate, FACT-BMT for transplant), symptom-specific versions (FACIT-Fatigue, FACT-Cog, FACT-GOG-Ntx for neuropathy, FACIT-Sp for spiritual well-being), and treatment-specific versions. A disease-specific instrument is built as the core 27 items plus an additional concerns subscale, so a FACT-B score contains a FACT-G score inside it.

FACIT-Fatigue deserves separate mention because it is the instrument behind most of the fatigue literature on this front. It came out of the FACT-Anemia work, which built scales to measure "fatigue and other anemia-related symptoms" within the FACT system, and is now used far outside anaemia.

FACT-G against QLQ-C30. They measure overlapping things and correlate well, but they are not interchangeable and a trial that reports one does not give you the other. FACT scores run higher is better throughout, including on the symptom-type items, which are worded and reverse-scored so that a higher score always means a better state. That is the opposite convention to the QLQ-C30 symptom scales and is the second commonest misreading in this field.

What it misses. Social and family well-being includes items about sexual activity that many respondents decline, which is a known source of missing data; the emotional subscale is short; and like the QLQ-C30 it has no fear of recurrence item. Licensing is also a practical limit: the FACIT measures require registration for permission to use, which is free for academic use but is a step a service has to take.

## Fields

- Kind: Technology
- Status: standard-of-care
- Last checked: 2026-10-02
- Tags: rejuvenation; survivorship; measurement; instruments
- Principle: A core 27-item general cancer measure with a four-domain structure, extended by additional concerns subscales for a disease, a symptom or a treatment, all scored in the same direction so that a higher total always means better reported well-being.
- Since: 1993
- Strengths: A very large validated family covering most cancers and many individual symptoms; Consistent scoring direction across every subscale; Short and readable, with a stated completion time of five to ten minutes; FACIT-Fatigue is the standard fatigue endpoint in cancer trials
- Limitations: Not interchangeable with the QLQ-C30, so trials using different instruments cannot be pooled directly; Sexual activity items generate predictable missing data; Requires registration for permission to use; No fear of recurrence item

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Functional_Assessment_of_Cancer_Therapy_-_General
- Cella et al., The Functional Assessment of Cancer Therapy scale: development and validation of the general measure (JCO 1993): https://doi.org/10.1200/JCO.1993.11.3.570
- Yellen et al., Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system (J Pain Symptom Manage 1997): https://doi.org/10.1016/S0885-3924(96)00274-6
- FACIT: FACT-G measure page: https://www.facit.org/measures/FACT-G
- Bell et al., Important differences and meaningful changes for the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) (J Patient Rep Outcomes 2018): https://doi.org/10.1186/s41687-018-0071-4

## Connected records

- technologies: [BREAST-Q and the Q-portfolio: measuring what an operation left behind](https://onco.cc/technologies/rejuv-measure-breast-q/), [EORTC QLQ-C30: the questionnaire most cancer trials use](https://onco.cc/technologies/rejuv-measure-eortc-qlq-c30/), [Fatigue after cancer treatment: what actually works](https://onco.cc/technologies/cancer-related-fatigue-management/), [How recovery is measured: the questionnaires behind the numbers](https://onco.cc/technologies/rejuv-measure-patient-reported-outcomes/), [Measuring memory and concentration after treatment](https://onco.cc/technologies/rejuv-measure-cognitive-function/), [PROMIS: the item banks that let a short questionnaire be precise](https://onco.cc/technologies/rejuv-measure-promis/), [Quality of life after transplant and cell therapy](https://onco.cc/technologies/rejuv-tx-quality-of-life/), [What a difference has to be before a person would notice it](https://onco.cc/technologies/rejuv-measure-minimally-important-difference/)
- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/), [Multiple myeloma](https://onco.cc/cancers/multiple-myeloma/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- fronts: [Recovery & Rejuvenation](https://onco.cc/fronts/rejuvenation/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- terms: [Cancer-related fatigue (tiredness)](https://onco.cc/terms/cancer-related-fatigue/), [Quality of life](https://onco.cc/terms/quality-of-life/)
- bottlenecks: [Patients lack understanding, navigation and agency](https://onco.cc/bottlenecks/b-patient-voice/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)

---
JSON: https://onco.cc/api/v1/entities/rejuv-measure-fact-and-facit.json