title: Increased prevalence of chronic fatigue among survivors of childhood cancers: a population-based study.
abstract: BACKGROUND
  Fatigue is prevalent in adult cancer survivors but less studied in childhood cancer survivors. Aims were to assess fatigue levels, prevalence of chronic fatigue (CF) and the association of CF with health-related quality of life (HRQoL) in survivors of acute myeloid leukemia (AML), infratentorial astrocytoma (IA), and Wilms tumor (WT) in childhood.
  
  
  METHODS
  Seventy percent (398/567) of Nordic patients treated for AML, IA, and WT between 1985 and 2001 at age >1 year responded to a postal survey, encompassing the Fatigue Questionnaire and the Short Form 36 (SF-36). Participants were divided into two groups at time of study; younger (YG, 13-18 years) and older (OG, 19-34 years). Respondents (19-34 years, n = 763) from a Norwegian general population (GP) survey served as controls for the OG.
  
  
  RESULTS
  The OG [mean age was 24 years (SD 3.3)] had higher fatigue levels compared to the YG and the GP, especially the females (P < 0.05). There was also a higher prevalence of CF in the OG than in the GP (14 vs. 6%, P < 0.001). Regardless of diagnosis, the OG with CF had poorer physical health (P < 0.05) on the SF-36 but better mental health (P < 0.05 and P = 0.001) relative to controls with CF.
  
  
  CONCLUSIONS
  The prevalence of CF is higher among Nordic survivors of AML, IA, and WT than GP controls of similar age. CF is associated with impaired HRQoL in survivors. However, they reported better mental health than CF GP controls. This might indicate different underlying mechanisms of CF in the two populations.
authors.affiliation: National Resource Center for Late Effects, Department of Oncology, Oslo University Hospital and University of Oslo, Montebello, Oslo, Norway. i.m.johannsdottir@medisin.uio.no
authors.forename: Inga M R
authors.initials: IM
authors.lastname: Jóhannsdóttir
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: Hjermstad
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Moum
authors.forename: Finn
authors.initials: F
authors.lastname: Wesenberg
authors.forename: Lars
authors.initials: L
authors.lastname: Hjorth
authors.forename: Henrik
authors.initials: H
authors.lastname: Schrøder
authors.forename: Susanna
authors.initials: S
authors.lastname: Mört
authors.forename: Gudmundur
authors.initials: G
authors.lastname: Jónmundsson
authors.forename: Jon H
authors.initials: JH
authors.lastname: Loge
mesh_terms: D000293:Adolescent; D000328:Adult; D001254:Astrocytoma / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D002908:Chronic Disease; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015192:Infratentorial Neoplasms / Q000453:epidemiology*; D007680:Kidney Neoplasms / Q000453:epidemiology*; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology*; D008297:Male; D005222:Mental Fatigue / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012044:Regression Analysis; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D017741:Survivors / Q000706:statistics & numerical data; D009396:Wilms Tumor / Q000453:epidemiology*