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Cited by 72Cancer survivorship and careCancer-related cognitive impairment studiesChildhood Cancer Survivors' Quality of Life

Prevalence and severity of long‐term physical, emotional, and cognitive fatigue across 15 different cancer entities

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Schmidt, Martina E., Hermann, Silke, Arndt, Volker, Steindorf, Karen·2020·Cancer Medicine
DOI 10.1002/cam4.3413PMC PMC7643651
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Abstract

Background: Fatigue prevalence and severity have been assessed in a variety of studies, yet, not in a standardized way, and predominantly in breast cancer patients. Systematic, comparative investigations across a broad range of cancer entities are lacking. Methods: The FiX study systematically enrolled 2244 cancer patients across 15 entities approximately 2 years after diagnosis. Fatigue was assessed with the multidimensional EORTC QLQ‐FA12 questionnaire. Physical, emotional, cognitive, and total fatigue were compared across entities and with normative values of the general population. Differences in patients' characteristics and cancer therapy between entities were taken into account using analyses of covariance models. Results: Across all entities, mean physical fatigue levels were significantly higher than age‐ and sex‐matched means of the general population for all cancer entities (all Bonferroni‐Holm adjusted P < .01). For most entities also emotional and cognitive fatigue levels were significantly higher than normative values. Age‐ and sex‐standardized physical fatigue prevalence ranged from 31.8% among prostate to 51.7% among liver cancer patients. Differences between entities could not be fully explained by sex, age, BMI, or cancer therapy. Adjusted for these factors, mean physical fatigue was higher for stomach (P = .0004), lung (P = .034), kidney (P = .0011), pancreas (P = .081), and endometrium (P = .022) compared to breast cancer patients. Adjusted means of emotional fatigue were also lowest in breast cancer patients and significantly higher in stomach (P = .0047), bladder (P = .0036), and rectal (P = .0020) cancer patients. Conclusions: Physical, emotional, and cognitive fatigue is prevalent in all 15 investigated cancer entities even 2 years after diagnosis. Fatigue in breast cancer patients, the so‐far most studied group, is in the lowest range among all entities, suggesting that the extent of fatigue is still insufficiently determined. Entity‐specific problems might need to be considered in the treatment of fatigue.

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  • Cancer-related fatigue prevalence ranges from 25% to more than 99% among patients undergoing cancer treatment.

    “CRF prevalence ranges from 25% to more than 99% among patients who are undergoing cancer treatment (Schmidt et al. 2020), and 19% to 82% among patients post-treatment (Aapro et al. 2017), with a meta-analysis of 84 studies involving over 144,000 subjects estimating an overall pooled prevalence of 52% across the entire disease trajectory (Ma et al. 2020).”

    From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as Schmidt et al. 2020

    The Introduction reports that fatigue prevalence during cancer treatment ranged from 25% to 99%. It supports the population and lower bound, but not the claim that the upper bound was more than 99%. (LLM, conf=0.88)

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  • Cancer-related fatigue is common in people living with cancer across the cancer care continuum, from diagnosis, during active treatment, and into long-term survivorship, and it is consistently listed as one of the top three bothersome symptoms, often described as the most distressing.

    “CRF is common in PLWC across the cancer care continuum, from the time of diagnosis, during active treatment, and into long-term survivorship, and it is consistently listed as one of the top three bothersome symptoms, often described as the most distressing (Schmidt et al. 2020).”

    From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as Schmidt et al. 2020

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Cited by

Sorted by citations

Authors
Schmidt, M. E., Hermann, S., Arndt, V., & Steindorf, K.
Affiliations
German Cancer Research Center (DE)
Corresponding author
Schmidt, Martina E.
ORCID
Venue
Cancer Medicine
Publisher
Wiley
Published
2020-09-07
Volume
9
Issue
21
Pages
8053-8061
ISSN
2045-7634 (ISSN-L)
DOI
10.1002/cam4.3413
PMC
PMC7643651
OpenAlex
W3084068165
Cited by
72
References
7
Citations by year
2026: 11 · 2025: 13 · 2024: 14 · 2023: 11 · 2022: 15 · 2021: 8
FWCI
3.07
Type
journal article
Language
en
Open access
Licence
Locations
  • Cancer Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
Keywords
cancer-related fatigue, physical fatigue, emotional fatigue, mental fatigue, cancer types, cancer survivors, fatigue prevalence, cancer therapy, breast cancer, gastric cancer, lung cancer, kidney cancer, endometrial cancer, bladder cancer, rectal cancer
MeSH terms
Psychological Distress, Adult, Aged, Aged, 80 and over, Cognition, Fatigue, Female, Germany, Health Status, Humans, Male, Mental Health, Middle Aged, Neoplasms, Quality of Life, Severity of Illness Index, Stress, Psychological, Prevalence, Cognitive Dysfunction

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