Development and Validation of the RCAC-7: A Simplified Unisex Scale for Reproductive Concerns in Adolescent and Young...

The original Reproductive Concerns After Cancer (RCAC) scale is a well-validated instrument. However, its gender-specific nature hinders direct comparison of scores across genders and limits its efficiency in clinical practice.

The study was conducted in two phases. First, items from the original female and male RCAC scales were rigorously evaluated and consolidated using a Delphi expert panel and face validity testing, resulting in a preliminary 7-item version. Second, psychometric validation was performed on a sample of 1,049 young cancer survivors (609 males, 440 females) recruited from two specialist oncology hospitals in China. Participants were diagnosed with a range of cancers, including colorectal, lung, breast, thyroid, gastric, and ovarian tumors. The psychometric evaluation encompassed item analysis, content validity, confirmatory factor analysis (CFA), convergent validity with the Patient Health Questionnaire-9 (PHQ-9), internal consistency reliability, and test-retest reliability.

The original 18-item scale was successfully reduced to a 7-item unisex instrument, the RCAC-7. Psychometric testing demonstrated that the RCAC-7 has satisfactory internal consistency (Cronbach's α = 0.770; McDonald's ω = 0.889) and excellent test-retest reliability (r = 0.930-0.970). The content validity index was good. Convergent validity was supported by a strong positive correlation with the PHQ-9 (r = 0.783, p < 0.01). Furthermore, confirmatory factor analysis confirmed a robust one-factor structure, indicating good model fit.

The RCAC-7 is a valid and reliable unisex tool for measuring reproductive concerns in young cancer survivors. Its brevity and strong psychometric properties make it highly suitable for rapid screening and use in both clinical practice and large-scale research settings.