The association of cancer‐related fatigue with all‐cause mortality of colorectal and endometrial cancer survivors: Results from the population‐based PROFILES registry

Abstract

Purpose Cancer‐related fatigue (CRF) is one of the most prevalent symptoms experienced by cancer survivors. However, researchers are only beginning to elucidate the risk factors, underlying mechanism(s), and its association with other outcomes. Research on the association between CRF and mortality is limited. Methods The study sample comprised 2059 short‐term (<5 years postdiagnosis) cancer survivors from four PROFILES registry studies. Survivors diagnosed with stage I‐III colorectal cancer (CRC) or stage I‐III endometrial cancer (EC), with no evidence of disease, were identified and followed‐up by the Netherlands Cancer Registry. Fatigue was assessed with the Fatigue Assessment Scale. Cox proportional hazards models adjusted for demographic, clinical, and lifestyle characteristics were performed to assess the association of CRF with all‐cause mortality. Date of censoring was February 1, 2017. Results Prevalence of CRF varied between 35.8% (male CRC) and 43.6% (female CRC). After a median follow‐up period of 9.0 years, a total of 408 survivors (20%) had died. CRF was associated with increased all‐cause mortality in male CRC survivors (HRadj = 1.75, 95% CI [1.31‐2.33]). This association remained statistically significant after excluding survivors experiencing anhedonia. For female CRC (HRadj = 1.32, 95% CI [0.90‐1.97]) and EC (HRadj = 1.27, 95% CI [0.84‐1.90]) survivors, there was no significant association with all‐cause mortality for the fatigued group in multivariable analyses. Conclusion Our study found that CRF is significantly associated with all‐cause mortality in male CRC survivors, irrespective of potential confounders. This result suggests that clinicians should increase their attention towards the recognition and treatment of CRF.

Identifying classes of the pain, fatigue, and depression symptom cluster in long-term prostate cancer survivors—results from the multi-regional Prostate Cancer Survivorship Study in Switzerland (PROCAS)

“…As the prevalence of comorbidities and intensity of fatigue are associated [40], this result is underlined by the large difference in the physical fatigue score between class 1 (mean 12.0) and class 3 (mean 53.5). This result regarding comorbidities is noteworthy, especially in view of previous research showing that there is a potential association between fatigue and increased risk of allcause mortality in male colorectal cancer survivors, in particular in those with comorbid heart disease [41]. Interestingly, two characteristics that differentiated survivors between class 2 and class 3 were doing more than 1.5 h of vigorous physical activities per week and being obese, such that PC survivors of class 2 were more active and had a lower BMI.…”

Cancer-Related Fatigue: Causes and Current Treatment Options

“…Medications to treat these conditions (e.g., beta-blockers, antidepressants) could also increase fatigue [ 39 ••]. Comorbid conditions are also associated with CRF in long-term survivorship [ 9 , 71 ].…”

“…Fatigued survivors are more likely to have reduced employment participation [ 4 , 5 ], greater financial stress [ 6 ], and higher healthcare utilization [ 6 , 7 ]. Moreover, fatigue may reduce survival; feeling fatigued at diagnosis [ 6 , 8 ] and during survivorship [ 9 ] is associated with higher mortality.…”

Cancer-related fatigue: Systematic reviews and meta-analyses of mind–body intervention

“…Fatigue is one of the most common symptoms among cancer patients (Alawneh et al, 2017;Mehnert et al, 2017), even in cancer survivors (patients with complete remission or no evidence of disease) (Adam et al, 2019). Around 45% of patients undergoing cancer treatment and 29% of patient survivors reported having moderate to severe fatigue (Wang et al, 2014).…”