title: Variation in fatigue among 6011 (long-term) cancer survivors and a normative population: a study from the population-based PROFILES registry.
abstract: OBJECTIVE
  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.
authors.affiliation: 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.
authors.forename: Olga
authors.initials: O
authors.lastname: Husson
authors.forename: Floortje
authors.initials: F
authors.lastname: Mols
authors.forename: Lonneke
authors.initials: L
authors.lastname: van de Poll-Franse
authors.forename: Jolanda
authors.initials: J
authors.lastname: de Vries
authors.forename: Goof
authors.initials: G
authors.lastname: Schep
authors.forename: Melissa S Y
authors.initials: MS
authors.lastname: Thong
mesh_terms: D000368:Aged; D015897:Comorbidity; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D011788:Quality of Life; D012042:Registries; D017741:Survivors