Normative Reference Values for the FACE-Q Skin Cancer Module: Patient Preoperative Scores and Comparison With Healthy Partners

Abstract Background The FACE-Q Skin Cancer Module is a condition-specific patient-reported outcome measure for facial skin cancer. While its psychometric properties have been established, normative reference values that enable score interpretation in clinical practice and research are lacking. Objective To establish normative reference values for the FACE-Q Skin Cancer Module using preoperative patient data and to validate these values by comparison with a demographically matched cohort of healthy partners. Methods Two cohorts were analyzed: 287 patients with facial skin cancer (preoperative scores) and 82 healthy partners of skin cancer patients (same-age population without facial skin cancer). Both cohorts completed the Appearance (9 items) and Psychosocial Distress (8 items) scales. Patients additionally completed the Cancer Worry scale (10 items) and Sun Protection scale (5 items). Scores were transformed to a 0–100 scale. Normative values were expressed as percentiles overall and stratified by sex and age group. Group comparisons used independent t-tests, Mann–Whitney U tests, and Cohen’s d. Internal consistency was assessed with Cronbach’s alpha. Results Patient and partner cohorts were well matched for age (68.6±11.9 vs 68.4±13.0, p=0.902) and sex (46.7% vs 41.5% female, p=0.476). Surprisingly, preoperative facial appearance scores were virtually identical between patients and partners (55.6±14.0 vs 56.6±13.6, p=0.590, d=−0.08), as were psychosocial distress scores (14.3±12.0 vs 14.4±13.3, p=0.942, d=−0.01). This equivalence held across age groups. A significant sex interaction was identified: female patients scored lower on appearance than female partners (54.3 vs 59.9, p=0.048, d=−0.40), whereas no difference existed among males (56.9 vs 53.1, p=0.168). Internal consistency was excellent in both cohorts (Cronbach’s α 0.82–0.93). Patients reported marginally higher sun protection behaviors than partners (38.0 vs 33.6, p=0.050). Conclusions Preoperative FACE-Q Skin Cancer scores in patients are equivalent to those of demographically matched healthy individuals, confirming that these scores serve as valid normative references. The established percentile norms enable clinicians and researchers to interpret individual patient scores in context. The sex-specific difference in appearance scores warrants further investigation.