Fatigue in adolescent and adult survivors of non-CNS childhood cancer: a report from project REACH

Studies of fatigue in childhood cancer survivors (CCS) are inconclusive, with some reporting increased fatigue prevalence in this population while others do not. Given the potentially significant consequences of unmanaged fatigue, we sought to estimate the prevalence of fatigue and to identify factors associated with fatigue in a population of non-CNS CCS ranging from adolescence to middle adulthood using a single fatigue measurement tool. Two hundred sixty-eight CCS ages 12-49 years followed in a survivorship clinic at a single cancer center completed validated self-report measures of fatigue, depression, and quality of life. Demographic and current health data were collected by study questionnaire and chart review Based on age-adjusted population norms, the prevalence of fatigue was 13.8 %, which is not significantly different compared to results in healthy populations. Fatigue was independently associated with having a parts per thousand yen3 chronic health conditions (OR 4.27, 95 % CI 1.52-11.99). Fatigued participants reported lower overall quality of life scores (OR 0.86, 95 % CI 0.82-0.89) and were more likely to be depressed compared to non-fatigued patients (20.4 vs. 1.4 %, respectively, p < 0.0001). There were 41(78.8 %) survivors with fatigue in our population who did not report significant depression. CCS did not demonstrate increased fatigue compared to age-matched normative data. Fatigued survivors were more likely to have multiple chronic conditions, depression, and decreased quality of life. Longitudinal study will promote better understanding of the relationship between fatigue and specific chronic conditions, thereby facilitating early identification of those individuals most at risk.