UNC HR/CSC Questionnaire


Conducting Interviews

UNC Health Registry conducted the first interview with newly enrolled participants within approximately 2 weeks of enrollment. Interviews were conducted over the phone or in-person. The baseline general interview took approximately 45 minutes.

To view the status of re-contact for baseline general interviews, click here.

  • Gender
  • Age
  • Race/ethnicity
  • Marital status
  • Education
  • Contact Information

Health History

  • Cancer screening
  • Reproductive history
  • Comorbidities
  • Medications
  • Cancer symptoms – Rotterdam*


  • Living conditions
  • Tobacco use
  • Alcohol use
  • Physical activity – GPAQ
  • Historical height/weight
  • Work impact - WAI
Patient Reported Outcomes (PRO)
  • Quality of life
  • General - SF-12 & PROMIS global
  • General cancer-specific – FACIT
  • Sexual function – PROMIS
  • Cognitive function – FACIT
  • Functional status – PG-SGA

Health Care System

  • Access to health care
  • Patient provider communication - PSQ-18
  • Referring Physician

Cancer Specific Topics

  • FACIT cancer-specific modules
  • Additional symptoms
  • Relevant cancer-specific topics

Baseline General Questionnaires were intended to be administered to all participants regardless of cancer type. To view the Baseline General Questionnaire, click here.
The cancer-specific questionnaire is tailored for individual cancer types. To view the Cancer-Specific Questionnaires, click on your specific topic of interest.