Jones Jennifer M, Howell Doris, Longo Christopher, Olson Karin, Bedard Philippe, Amir Eitan, Zheng Shiyu, Chow Brittany, Avery Lisa
Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre and Department of Psychiatry, University of Toronto, 200 Elizabeth Street, B-PMB-045, Toronto, ON, M5G 2C4, Canada.
Department of Supportive Care, Princess Margaret Cancer Centre and Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
J Cancer Surviv. 2025 Feb;19(1):97-108. doi: 10.1007/s11764-023-01451-9. Epub 2023 Aug 30.
Cancer-related fatigue (CRF) is well documented in cancer survivors, but little is known about the personal and societal impact of CRF. This study aimed to examine the impact of CRF in relation to social and vocational functioning and health care utilization in a large sample of post-treatment cancer survivors.
We conducted a cross-sectional descriptive study of early stage breast and colorectal cancer survivors (n = 454) who were within 5 years from treatment completion. Social difficulties (SDI-21), work status, absenteeism and presenteeism (WHO-HPQ) and healthcare utilization (HSUQ) were compared in those with (CFR +) and without (CRF -) clinically significant fatigue (FACT-F ≤ 34).
A total of 32% met the cut-off criteria for CRF (≤ 34). Participants with CRF + had significantly higher scores on the SDI-21 across all domains and 55% of CRF + vs. 11% in CRF - was above the SDI cut-off (> 10) for significant social difficulties. Participants with CRF + were 2.74 times more likely to be unemployed or on leave (95% CI 1.62, 4.61, p < 0.001). In the subgroup of participants who were currently working (n = 249), those with CRF + reported working on average 27.4 fewer hours in the previous 4 weeks compared to CRF - (p = 0.05), and absolute presenteeism was on average 13% lower in the CRF + group (95% CI 8.0, 18.2, p < 0.001). Finally, individuals with CRF + reported significantly more physician (p < 0.001), other health care professional (p = 0.03) and psychosocial visits (p = 0.002) in the past month.
CRF is associated with substantial disruption in social and work role functioning in the early transitional phase of cancer survivorship. Better management of persistent CRF and funding for the implementation of existing guidelines and recommended evidence-based interventions are urgently needed.
癌症相关疲劳（CRF）在癌症幸存者中已有充分记录，但关于CRF对个人和社会的影响却知之甚少。本研究旨在调查CRF对大量治疗后癌症幸存者的社会和职业功能以及医疗保健利用的影响。
我们对完成治疗后5年内的早期乳腺癌和结直肠癌幸存者（n = 454）进行了一项横断面描述性研究。比较了有（CFR +）和无（CRF -）临床显著疲劳（FACT - F≤34）者的社会困难（SDI - 21）、工作状态、旷工和出勤情况（WHO - HPQ）以及医疗保健利用情况（HSUQ）。
共有32%的人符合CRF的截断标准（≤34）。CRF +参与者在所有领域的SDI - 21得分均显著更高，CRF +组中有55%的人高于SDI截断值（> 10）表示存在显著社会困难，而CRF -组中这一比例为11%。CRF +参与者失业或休假的可能性高出2.74倍（95% CI 1.62, 4.61，p < 0.001）。在目前仍在工作的参与者亚组（n = 249）中，CRF +参与者报告在前4周内平均工作时长比CRF -参与者少27.4小时（p = 0.05），且CRF +组的绝对出勤主义平均低13%（95% CI 8.0, 18.2，p < 0.001）。最后，CRF +个体报告在过去一个月中看医生（p < 0.001）、看其他医疗保健专业人员（p = 0.03）和进行心理社会咨询（p = 0.002）的次数显著更多。
在癌症幸存者的早期过渡阶段，CRF与社会和工作角色功能的严重紊乱有关。迫切需要更好地管理持续性CRF，并为实施现有指南和推荐的循证干预措施提供资金。
