Levinsen Anne Katrine Graudal, Dalton Susanne Oksbjerg, Jakobsen Erik, Gögenur Ismail, Borre Michael, Zachariae Robert, Christensen Peter, Laurberg Søren, de Nully Brown Peter, Hölmich Lisbet Rosenkrantz, Johansen Christoffer, Kjær Susanne K, van de Poll-Franse Lonneke, Kjaer Trille Kristina
Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark.
Danish Research Center for Equality in Cancer, Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark.
J Cancer Surviv. 2025 Jun 14. doi: 10.1007/s11764-025-01851-z.
To identify risk factors and patient characteristics in survivors who report clinically important fatigue, pain, and insomnia.
Cross-sectional study including 39,374 survivors of breast, prostate, lung, colon, rectum cancer, melanoma, and lymphoma diagnosed at age 40 or older between Jan 2010 and Dec 2019. Prevalences and odds ratios (ORs) with 95% confidence intervals (CI) for clinically important fatigue, pain, and insomnia by sociodemographic, clinical, and lifestyle factors were calculated.
Among all survivors, 42% reported clinically important fatigue, pain, or insomnia, and 21% reported concurring symptoms. Prevalences were highest in women, survivors of breast and lung cancer, with short education, low income, comorbidity, obesity, and smokers. Adjusted analyses showed increased odds in women (OR fatigue 1.46, 95% CI 1.39-1.54; OR pain 1.62, 95% CI 1.55-1.70; OR insomnia 2.11, 95% CI 1.99-2.24), survivors with comorbidity (OR fatigue 2.97, 95% CI 2.78-3.18; OR pain 2.13, 95% CI 2.00-2.27; OR insomnia 1.67, 95% CI 1.55-1.80), smokers (OR fatigue 1.96, 95% CI 1.80-2.13; OR pain 1.67, 95% CI 1.55-1.81; OR insomnia 1.46, 95% CI 1.33-1.60), and survivors with obesity (OR fatigue 1.92, 95% CI 1.80-2.06; OR pain 2.21, 95% CI 2.08-2.35; OR insomnia 1.32, 95% CI 1.22-1.42).
Clinically important fatigue, pain, or insomnia are common in survivors of cancer, and two in five report two or all three late effects. Report of these symptoms is associated with social and clinical vulnerability factors.
Management of survivorship care requires targeted consideration of the complexity and overall impact of these late effects.
确定报告有临床上显著疲劳、疼痛和失眠的癌症幸存者的风险因素及患者特征。
横断面研究，纳入2010年1月至2019年12月期间确诊的年龄在40岁及以上的39374例乳腺癌、前列腺癌、肺癌、结肠癌、直肠癌、黑色素瘤和淋巴瘤幸存者。计算了社会人口统计学、临床和生活方式因素导致临床上显著疲劳、疼痛和失眠的患病率及优势比（OR）和95%置信区间（CI）。
在所有幸存者中，42%报告有临床上显著的疲劳、疼痛或失眠，21%报告有并发症状。患病率在女性、乳腺癌和肺癌幸存者、受教育程度低、低收入、有合并症、肥胖者以及吸烟者中最高。校正分析显示，女性（OR疲劳1.46，95%CI 1.39 - 1.54；OR疼痛1.62，95%CI 1.55 - 1.70；OR失眠2.11，95%CI 1.99 - 2.24）、有合并症的幸存者（OR疲劳2.97，95%CI 2.78 - 3.18；OR疼痛2.13，95%CI 2.00 - 2.27；OR失眠1.67，95%CI 1.55 - 1.80）、吸烟者（OR疲劳1.96，95%CI 1.80 - 2.13；OR疼痛1.67，95%CI 1.55 - 1.81；OR失眠1.46，95%CI 1.33 - 1.60）以及肥胖的幸存者（OR疲劳1.92，95%CI 1.80 - 2.06；OR疼痛2.21，95%CI 2.08 - 2.35；OR失眠1.32，95%CI 1.22 - 1.42）的优势比增加。
临床上显著的疲劳、疼痛或失眠在癌症幸存者中很常见，五分之二的人报告有两种或全部三种晚期效应。这些症状的报告与社会和临床脆弱性因素相关。
癌症幸存者护理的管理需要有针对性地考虑这些晚期效应的复杂性和总体影响。
