Table 7  Recommendations from the S3-guideline “Psycho-oncological Diagnosis, Counseling and Treatment of Adult Cancer Patients,” Version 1.1, updated June 2021.

No.	Text of recommendation
11.3	Psychosocial problems and the individual level of need for psycho-oncological support should be recorded as early as possible and should be repeatedly reviewed over the course of disease.
11.4	All patients must be screened for psychosocial problems. Psycho-oncological screening should be carried out as early as possible and repeated at reasonable intervals over the course of disease, when clinically indicated, or if there are changes in the patientʼs disease status (e.g., recurrence or progression of disease); screening should also be carried out in long-term survivors.
11.5	Validated and standardized screening tools must be used to record psychosocial problems. The screening tools which must be used include the Distress Thermometer (DT), the Hospital Anxiety and Depression Scale (HADS), the questionnaire on the stress of cancer patients (FBK), the Depression module of the Patient Health Questionnaire (PHQ-9) or the Generalized Anxiety Disorder Scale-7 (GAD-7) (LoE 1b).
11.6	In addition to screening to identify problems, the patient must be asked about her subjective psychosocial need for support (EC).
11.7	A diagnostic discussion to evaluate psychosocial problems and psychological comorbidities must follow if screening results are positive and/or at the patientʼs request.
11.8	Further diagnostic evaluation should follow, based on the individual psychological/social/somatic problems identified in the discussion.