Prevalence and biopsychosocial indicators of fatigue in cancer patients

Elisabeth L Zeilinger, Irina Zrnic-Novakovic, Claudia Oppenauer, Matthäus Fellinger, Matthias Knefel, Matthias Unseld, Theresa Wagner, Simone Lubowitzki, Rupert Bartsch, Sabine Zöchbauer-Müller, Markus Raderer, Philipp B Staber, Peter Valent, Alexander Gaiger

Research output: Journal article (peer-reviewed)Journal article


INTRODUCTION: Symptoms of cancer-related fatigue (CRF) can have a significant impact on patients' quality of life and treatment adherence. We aimed to investigate the relationship between CRF and multiple psychosocial and somatic indicators within a large mixed cancer sample.

METHODS: In this cross-sectional study, N = 1787 outpatients with cancer were assessed for CRF, pain, anxiety, and depression using validated screening instruments. We further obtained clinical parameters (Hb, CRP, creatinine, leukocytes, ASAT, and ALAT), sociodemographic data (age, gender, income, education level, marital status, parenthood, and living area), and lifestyle factors. Multivariate linear regression models were applied to estimate the impact of each indicator on CRF.

RESULTS: Overall, 90.6% of patients experienced some CRF, with 14.8% experiencing severe CRF. No gender difference was found in the prevalence of CRF. Patients with higher levels of pain, depressive symptoms, and lower Hb levels had significantly higher levels of CRF (ps <0.001). Lower levels of CRF were observed in patients who had children (p = 0.03), had less education (p < 0.001), and were physically active for more than 2 h per week before their oncological diagnosis (p = 0.014). The latter was only a significant indicator in the male subsample.

CONCLUSION: The present results demonstrate a high prevalence of CRF and highlight that not only somatic and psychosocial factors, but also lifestyle factors prior to diagnosis appear to be associated with the etiology and persistence of CRF. To effectively treat CRF, a biopsychosocial, personalized approach is recommended.

Original languageEnglish
Article numbere7293
Pages (from-to)e7293
JournalCancer Medicine
Issue number11
Publication statusPublished - Jun 2024


  • Humans
  • Male
  • Female
  • Neoplasms/complications
  • Fatigue/epidemiology
  • Middle Aged
  • Cross-Sectional Studies
  • Prevalence
  • Aged
  • Depression/epidemiology
  • Quality of Life
  • Adult
  • Anxiety/epidemiology


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