Seventy consecutively admitted Chinese patients with advanced cancer and pain (mean age 62 years) were evaluated with the Chinese version of the Hospital Anxiety and Depression Scale (HADS), and with the Geriatric Depression Scale (GDS) Short Form (for patients 65 years old or over) in a prospective study. The HADS and GDS had good concordance (kappa = 0.53). By these depression screening tests, the prevalence of probable depression was 41-49%, and the prevalence of definite depression (HADS > or = 11) was 29%. There was no difference in age, gender and educational level; no difference in nature and severity of pain; and no difference in the level of disability between depressed (using HADS > or = 11) and nondepressed patients with advanced cancer. The study suggests that depression does not correlate with the severity of pain in patients with advanced cancer. It also suggests that impaired activity of daily living (ADL) in these patients is not related to depression.