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Background Palliative care improves the quality of life of patients with cancer. The development and utilization of palliative care needs screening tools can help health care providers rapidly, accurately, and scientifically identify cancer patients with palliative care needs and enable health care providers to provide them with palliative care related services in a more timely manner. Currently, the literature on screening tools for palliative care needs in China is less common. Objective To hance the palliative care needs screening tool (PCST) and test its validity in hospitalized cancer patients. Methods The PCST was bidirectionally translated following the Brislin translational model. Cultural commissioning of the Chinese version of PCST through expert panel meetings and pre survey. A total of 173 cancer patients admitted to the Department of oncology, biotherapeutics, interventional, and integrative medicine of the Third Affiliated Hospital of Navy Military Medical University were selected for the study from December 2020 to May 2021 using convenience sampling, and the general information questionnaire, Chinese version of PCST were used for this investigation. The critical ratio method and correlation of the item-total scores were used for item analysis, and the content validity of the scale was assessed by expert scoring. To evaluate the validity of known-groups, the palliative care needs screening results of patients with different characteristics were compared. Cronbach's α Coefficient and Guttman compromise coefficient were used to evaluate the internal consistency of the scale. Pearson correlation was used to evaluate the inter rater reliability and test-retest reliability of the scale. Results The Chinese version of the PCST includes 10 items, with scores ranging from 0 to 14 points. The CR values of entries ranged from 0.621 to 8.820, and all entries except entries 1 and 8 achieved significant values (P |