{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T06:39:07Z","timestamp":1780382347701,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Fatigue prevalence and severity have been assessed in a variety of studies, yet, not in a standardized way, and predominantly in breast cancer patients. Systematic, comparative investigations across a broad range of cancer entities are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The FiX study systematically enrolled 2244 cancer patients across 15 entities approximately 2\u00a0years after diagnosis. Fatigue was assessed with the multidimensional EORTC QLQ\u2010FA12 questionnaire. Physical, emotional, cognitive, and total fatigue were compared across entities and with normative values of the general population. Differences in patients' characteristics and cancer therapy between entities were taken into account using analyses of covariance models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Across all entities, mean physical fatigue levels were significantly higher than age\u2010 and sex\u2010matched means of the general population for all cancer entities (all Bonferroni\u2010Holm adjusted <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01). For most entities also emotional and cognitive fatigue levels were significantly higher than normative values. Age\u2010 and sex\u2010standardized physical fatigue prevalence ranged from 31.8% among prostate to 51.7% among liver cancer patients. Differences between entities could not be fully explained by sex, age, BMI, or cancer therapy. Adjusted for these factors, mean physical fatigue was higher for stomach (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0004), lung (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.034), kidney (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0011), pancreas (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.081), and endometrium (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.022) compared to breast cancer patients. Adjusted means of emotional fatigue were also lowest in breast cancer patients and significantly higher in stomach (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0047), bladder (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0036), and rectal (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0020) cancer patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Physical, emotional, and cognitive fatigue is prevalent in all 15 investigated cancer entities even 2\u00a0years after diagnosis. Fatigue in breast cancer patients, the so\u2010far most studied group, is in the lowest range among all entities, suggesting that the extent of fatigue is still insufficiently determined. Entity\u2010specific problems might need to be considered in the treatment of fatigue.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.3413","type":"journal-article","created":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T07:57:54Z","timestamp":1600070274000},"page":"8053-8061","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Prevalence and severity of long\u2010term physical, emotional, and cognitive fatigue across 15 different cancer entities"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2095-2426","authenticated-orcid":false,"given":"Martina E.","family":"Schmidt","sequence":"first","affiliation":[{"name":"Division of Physical Activity, Prevention and Cancer National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Hermann","sequence":"additional","affiliation":[{"name":"Epidemiological Cancer Registry Baden\u2010W\u00fcrttemberg German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9320-8684","authenticated-orcid":false,"given":"Volker","family":"Arndt","sequence":"additional","affiliation":[{"name":"Epidemiological Cancer Registry Baden\u2010W\u00fcrttemberg German Cancer Research Center (DKFZ) Heidelberg Germany"},{"name":"Division of Clinical Epidemiology and Aging Research German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5215-5651","authenticated-orcid":false,"given":"Karen","family":"Steindorf","sequence":"additional","affiliation":[{"name":"Division of Physical Activity, Prevention and Cancer National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.12-S1-4"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-011-0197-3"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2014.127"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.6914"},{"key":"e_1_2_11_6_1","unstructured":"Network NCC.NCCN Clinical Practice Guidelines in Oncology: cancer\u2010related fatigue version 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