The association of cancer-related fatigue with all-cause mortality of colorectal and endometrial cancer survivors

Results from the population-based PROFILES registry

Salome Adam, Lonneke V van de Poll-Franse, Floortje Mols, Nicole P M Ezendam, Ignace H J T de Hingh, Volker Arndt, Melissa S Y Thong*

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

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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.

Original languageEnglish
Pages (from-to)3227-3236
JournalCancer Medicine
Volume8
Issue number6
DOIs
Publication statusPublished - 2019

Fingerprint

Endometrial Neoplasms
Survivors
Neoplasms
Anhedonia
Second Primary Neoplasms
Proportional Hazards Models
Netherlands

Keywords

  • DEPRESSION
  • GENDER-DIFFERENCES
  • INITIAL TREATMENT
  • LONG-TERM EVALUATION
  • LUNG-CANCER
  • PATIENT-REPORTED OUTCOMES
  • POSITIVE AFFECT ANHEDONIA
  • PSYCHOMETRIC QUALITIES
  • QUALITY-OF-LIFE
  • STATISTICS
  • all-cause mortality
  • cancer-related fatigue
  • colorectal cancer
  • endometrial cancer

Cite this

@article{a4b34298d82547cfb445716cdd1b338b,
title = "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.",
keywords = "DEPRESSION, GENDER-DIFFERENCES, INITIAL TREATMENT, LONG-TERM EVALUATION, LUNG-CANCER, PATIENT-REPORTED OUTCOMES, POSITIVE AFFECT ANHEDONIA, PSYCHOMETRIC QUALITIES, QUALITY-OF-LIFE, STATISTICS, all-cause mortality, cancer-related fatigue, colorectal cancer, endometrial cancer",
author = "Salome Adam and {van de Poll-Franse}, {Lonneke V} and Floortje Mols and Ezendam, {Nicole P M} and {de Hingh}, {Ignace H J T} and Volker Arndt and Thong, {Melissa S Y}",
year = "2019",
doi = "10.1002/cam4.2166",
language = "English",
volume = "8",
pages = "3227--3236",
journal = "Cancer Medicine",
issn = "2045-7634",
publisher = "John Wiley and Sons Ltd",
number = "6",

}

The association of cancer-related fatigue with all-cause mortality of colorectal and endometrial cancer survivors : Results from the population-based PROFILES registry. / Adam, Salome; van de Poll-Franse, Lonneke V; Mols, Floortje; Ezendam, Nicole P M; de Hingh, Ignace H J T; Arndt, Volker; Thong, Melissa S Y.

In: Cancer Medicine, Vol. 8, No. 6, 2019, p. 3227-3236.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - The association of cancer-related fatigue with all-cause mortality of colorectal and endometrial cancer survivors

T2 - Results from the population-based PROFILES registry

AU - Adam, Salome

AU - van de Poll-Franse, Lonneke V

AU - Mols, Floortje

AU - Ezendam, Nicole P M

AU - de Hingh, Ignace H J T

AU - Arndt, Volker

AU - Thong, Melissa S Y

PY - 2019

Y1 - 2019

N2 - 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.

AB - 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.

KW - DEPRESSION

KW - GENDER-DIFFERENCES

KW - INITIAL TREATMENT

KW - LONG-TERM EVALUATION

KW - LUNG-CANCER

KW - PATIENT-REPORTED OUTCOMES

KW - POSITIVE AFFECT ANHEDONIA

KW - PSYCHOMETRIC QUALITIES

KW - QUALITY-OF-LIFE

KW - STATISTICS

KW - all-cause mortality

KW - cancer-related fatigue

KW - colorectal cancer

KW - endometrial cancer

U2 - 10.1002/cam4.2166

DO - 10.1002/cam4.2166

M3 - Article

VL - 8

SP - 3227

EP - 3236

JO - Cancer Medicine

JF - Cancer Medicine

SN - 2045-7634

IS - 6

ER -