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Variation in fatigue among 6011 (long-term) cancer survivors and a normative population: a study from the population-based PROFILES registry

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Abstract

Purpose

Cancer survivors commonly experience fatigue, related to disease and its treatment. This study aimed to compare fatigue severity among survivors of different cancer types with a normative population and also to identify variations in fatigue among cancer survivors according to clinical and demographic variables.

Methods

We used cancer survivorship data from the population-based PROFILES registry. We included survivors of endometrial (EC, n = 741) or colorectal cancer (CRC, n = 3878) (1998–2007), thyroid cancer (TC, n = 306) (1990–2008), Hodgkin (HL, n = 150) or non-Hodgkin lymphoma (NHL, n = 716), or multiple myeloma (MM, n = 120) (1999–2008). A representative Dutch normative population (n = 2040) was also assessed. Participants completed the Fatigue Assessment Scale.

Results

Cancer survivors were more often classified as fatigued (EC/CRC 39 %, HL 40 %, NHL 43 %, MM 51 %, TC 44 %) compared with the normative population (21 %; p < 0.001). MM survivors were more often classified as fatigued than all other cancer groups, except NHL (overall p = 0.02). Shorter times since diagnosis (<5 years, 41 versus 38 %; p < 0.05), younger age (≤65 years, 42 versus 39 %; p < 0.01), being female (43 versus 36 %; p < 0.01), chemotherapy treatment (43 versus 39 %; p < 0.01), comorbidity (no (27 %) versus 1 (35 %) versus ≥2 (52 %); p < 0.01), educational level (low (44 %) versus medium (41 %) versus high (32 %); p < 0.01), and absence of a partner (47 versus 38 %; p < 0.01) were associated with fatigue.

Conclusions

Fatigue levels are substantial in (long-term) cancer survivors and vary depending on cancer type, time since diagnosis, age, gender, treatment with chemotherapy, number of comorbid conditions, educational level, and partnership. Since significantly more cancer survivors feel fatigued in comparison with the normative population, appropriate information, assessment, and interventions for fatigue are needed during or after oncologic treatment. Furthermore, focus on better control or management of comorbid conditions of cancer survivors is recommended.

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Acknowledgments

We thank all survivors and their doctors for their participation in the study. Special thanks to Dr. M. van Bommel for her availability as an independent advisor and willingness to answer survivors’ queries. In addition, we thank the following hospitals for their cooperation: Amphia Hospital (Breda), Bernhoven Hospital (Veghel and Oss), Catharina Hospital (Eindhoven), Elkerliek Hospital (Helmond), Jeroen Bosch Hospital (‘s Hertogenbosch), Maxima Medical Center (Eindhoven and Veldhoven), St. Anna Hospital (Geldrop), St. Elisabeth Hospital (Tilburg), Twee Steden Hospital (Tilburg and Waalwijk), and VieCuri Hospital (Venlo and Venray).

Funding

The present research is supported in part by a Veni grant (no. 451-10-041) from the Netherlands Organization for Scientific Research (The Hague, The Netherlands) awarded to Floortje Mols, a Cancer Research Award from the Dutch Cancer Society (no. UVT-2009-4349) to Lonneke van de Poll-Franse and a Social Psychology Fellowship from the Dutch Cancer Society to Melissa Thong (no. UVT2011-4960). Data collection for this study was funded by the Comprehensive Cancer Centre South, Eindhoven, The Netherlands; the Center of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, The Netherlands; and an investment subsidy (no. 480-08-009) of the Netherlands Organization for Scientific Research (The Hague, The Netherlands). The funding sources were neither involved in the collection, interpretation, and analysis of the data, nor in the decision for the writing and submission of this report for publication.

Conflict of interest

None declared.

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Authors and Affiliations

  1. CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands

    Olga Husson, Floortje Mols, Lonneke van de Poll-Franse, Jolanda de Vries & Melissa S. Y. Thong

  2. Eindhoven Cancer Registry, Comprehensive Cancer Centre Netherlands, Eindhoven, The Netherlands

    Floortje Mols, Lonneke van de Poll-Franse & Melissa S. Y. Thong

  3. Department of Medical Psychology, St. Elisabeth Hospital, Tilburg, The Netherlands

    Jolanda de Vries

  4. Department of Sports Medicine (SportMáx), Maxima Medical Center, Veldhoven, The Netherlands

    Goof Schep

Authors
  1. Olga Husson
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  2. Floortje Mols
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  3. Lonneke van de Poll-Franse
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  4. Jolanda de Vries
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  5. Goof Schep
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  6. Melissa S. Y. Thong
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Correspondence to Melissa S. Y. Thong.

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Husson, O., Mols, F., van de Poll-Franse, L. et al. Variation in fatigue among 6011 (long-term) cancer survivors and a normative population: a study from the population-based PROFILES registry. Support Care Cancer 23, 2165–2174 (2015). https://doi.org/10.1007/s00520-014-2577-5

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