title: Clinically relevant fatigue in cancer outpatients: the Edinburgh Cancer Centre symptom study.
abstract: BACKGROUND
  Fatigue is associated with cancer and its treatment but we know little about how many and which patients suffer fatigue of clinical severity. We aimed to determine the prevalence of clinically relevant fatigue (CRF) and its associations in outpatients with various cancer diagnoses.
  
  
  METHODS
  A survey of outpatients with colorectal, breast, gynaecological, genitourinary, sarcoma, melanoma and miscellaneous tumours at a regional cancer centre. Patients completed the European Organisation for Research and Treatment of Cancer (EORTC) fatigue subscale and the Hospital Anxiety and Depression Scale (HADS). These self-report data were linked to demographic and clinical variables. Data were available on 2867 outpatients.
  
  
  RESULTS
  The prevalence of CRF (EORTC fatigue subscale > or =40) was 32% (95% confidence interval 31-34%). The variables independently associated with CRF were primary cancer site, having disease present, type of cancer treatment and emotional distress (total HADS score > or =15). Emotional distress had the strongest association with fatigue but half the cases of CRF were not distressed.
  
  
  CONCLUSIONS
  CRF is common in cancer outpatients and is associated with type of disease and treatment, as well as with emotional distress. The association between CRF and emotional distress is strong but they are not equivalent conditions.
authors.affiliation: Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK. drdjs@talk21.com
authors.forename: D J
authors.initials: DJ
authors.lastname: Storey
authors.forename: R A
authors.initials: RA
authors.lastname: Waters
authors.forename: C J
authors.initials: CJ
authors.lastname: Hibberd
authors.forename: R W
authors.initials: RW
authors.lastname: Rush
authors.forename: A T
authors.initials: AT
authors.lastname: Cargill
authors.forename: L R
authors.initials: LR
authors.lastname: Wall
authors.forename: M T
authors.initials: MT
authors.lastname: Fallon
authors.forename: V A
authors.initials: VA
authors.lastname: Strong
authors.forename: J
authors.initials: J
authors.lastname: Walker
authors.forename: M
authors.initials: M
authors.lastname: Sharpe
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001007:Anxiety / Q000453:epidemiology / Q000503:physiopathology; D002173:Cancer Care Facilities; D015984:Causality; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D017678:Sex Distribution; D012803:Sick Role; D018434:Sickness Impact Profile; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology