# Translation, cultural adaptation, and pilot testing of the German cancer worry scale among BRCA1/2 pathogenic variant carriers in Austria

## TL;DR

This study created a German version of a cancer worry scale for BRCA1/2 carriers in Austria, ensuring it is culturally adapted and easy to understand.

## Contribution

The first pilot-tested German version of the 8-item Cancer Worry Scale for BRCA1/2 pathogenic variant carriers.

## Key findings

- Thirty-five BRCA1/2 carriers found the translated scale mostly understandable, with four items revised for clarity.
- Women without risk-reducing surgery reported higher cancer worry, while men were more concerned about family health.
- The study supports the feasibility of the German Cancer Worry Scale but calls for further validation in larger populations.

## Abstract

Cancer-related worry can significantly impact psychosocial wellbeing and decision-making, especially among individuals with hereditary cancer risk. Although the Cancer Worry Scale is a commonly used instrument, no culturally adapted version exists for German speaking populations. This study aimed to translate, culturally adapt and pilot-test a German version of the 8-item Cancer Worry Scale in individuals carrying BRCA1 or BRCA2 pathogenic variants in Austria.

The scale was translated using a forward and backward translation process, and reviewed by an expert panel. Participants were recruited from a familial cancer clinic and completed the translated scale along with demographic questions. Participants provided feedback on item clarity and comprehension, which informed minor revisions. The final version was then pilot-tested with a small sample of BRCA1/2 carriers.

Thirty-five individuals with BRCA1/2 pathogenic variants completed the scale. Most participants found the scale understandable, though eight reported difficulties with certain items. Based on this feedback, four items were revised to improve clarity. Descriptive analysis indicated similar worry patterns to those observed in international studies. Women who had not undergone risk-reducing surgery reported higher cancer worry, while male participants expressed elevated concern primarily for the health of their family members.

This pilot study presents the first pilot-tested German version of the 8-item Cancer Worry Scale. While initial results support its feasibility and comprehension, further research is needed to validate the psychometric properties of the instrument in larger German-speaking populations.

The online version contains supplementary material available at 10.1186/s13053-025-00316-9.