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Prevalence and risk factors of cancer-related fatigue: A systematic review and meta-analysis
Abstract
Background Cancer-related fatigue, one of the most frequent side-effects of cancer treatment, affects the well-being of patients. Despite the fact that the estimated prevalence and risk factors of cancer-related fatigue are widely reported, these results have not been synthesized.Objectives To systematically assess the prevalence of cancer-related fatigue, including stratification by fatigue degree, sex, age, therapeutic method, cancer-related fatigue scales, countries, and risk factors for cancer-related fatigue.Design Systematic literature review and meta-analysis.Data sources PubMed, Cochrane Library, Web of Science, CINAHL Plus, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM), and Weipu Database (VIP) were comprehensively searched for observational studies investigating the prevalence and risk factors of cancer-related fatigue from inception to March 31st, 2019.Review methods Original journal articles were included which met the inclusion criteria. The quality of the included studies was evaluated independently by two investigators. Meta-analysis was conducted using Stata 12.0 software package, with estimates of cancer-related fatigue from pooled using a random-effects model.Results In total, 2641 articles were screened and data from 84 studies involving 144,813 subjects were used in meta-analysis. The prevalence of cancer-related fatigue in individual studies varied from 14.03% to 100%. The pooled prevalence of cancer-related fatigue was 52% (95% confidence interval, CI: 48% to 56%, I 2 = 99.7%, P < 0.0001). After controlling for confounding variables, the following risk factors were associated with cancer-related fatigue: poor performance status (odds ratio, OR = 6.58, 95% CI: 2.60 to 16.67, I 2 = 75.2%, P < 0.0001), chemoradiotherapy (OR = 2.25, 95% CI: 1.90 to 2.67, I 2 =0%, P<0.0001), female sex (OR = 2.07, 95% CI: 1.51 to 2.84, I 2 = 41.2%, P<0.0001), insomnia (OR = 2.83, 95% CI: 1.22 to 6.57, I 2 = 98.3%, P = 0.015), neuroticism (OR = 1.23, 95% CI: 1.05 to 1.43, I 2 = 88.9%, P = 0.01), pain (OR = 2.64, 95% CI: 1.20 to 5.80, I 2 = 95.3%, P = 0.016), and depression (OR = 2.23, 95% CI: 1.70 to 2.93, I 2 = 98.1%, P < 0.0001).Conclusion The current analysis indicates an overall pooled prevalence of cancer-related fatigue of 52%. Poor performance status, chemoradiotherapy, female sex, insomnia, neuroticism, pain, and depression were identified as risk factors for cancer-related fatigue. Understanding the risk factors of cancer-related fatigue can provide the healthcare personnel with the theoretical basis for the management and treatment of the patients.
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“The incidence and severity of fatigue is also higher in females. 17”
From Mindfulness and Psychosocial Symptoms in People with Cancer: Testing Rumination and Experiential Avoidance as Mediators, and Sex as a Moderator. (2025) · cites this paper as [17]
In the citing paper
“fatigue is closely associated cross-sectionally with rumination and constructs mediated by rumination such as anxiety and depression.1,17,22,25,44”
From Mindfulness and Psychosocial Symptoms in People with Cancer: Testing Rumination and Experiential Avoidance as Mediators, and Sex as a Moderator. (2025) · cites this paper as [17]
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Prevalence of cancer-related fatigue based on severity: a systematic review and meta-analysis
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Metadata
- Authors
- Ma, Y., He, B., Jiang, M., Yang, Y., Wang, C., Huang, C., & Han, L.
- Affiliations
- Lanzhou University (CN)
- Gansu University of Traditional Chinese Medicine (CN)
- Gansu Provincial Hospital (CN)
- Corresponding author
- Han, Lin
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2020-11
- Volume
- 111
- Pages
- 103707
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W3041694213
- Cited by
- 326
- References
- 90
- Citations by year
- 2026: 58 · 2025: 88 · 2024: 76 · 2023: 50 · 2022: 40 · 2021: 12 · 2020: 1
- FWCI
- 2.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Nursing Studies (publishedVersion)
- PubMed (publishedVersion)
- Lanzhou University Institutional Repository (submittedVersion)
- Funders
- Fundamental Research Funds for the Central Universities (lzujbky-2018-ct05, lzujbky-2020–10, lzujbky-2016-ct14, lzujbky-2018–77)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- cancer-related fatigue, prevalence, risk factors, performance status, chemoradiotherapy, insomnia, sex differences, cancer treatment side effects, fatigue severity, cancer patients, quality of life, prognostic factors, prognostic risk score
- MeSH terms
- China, Fatigue, Female, Humans, Neoplasms, Risk Factors, Prevalence
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