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Cancer-Related Fatigue in Head and Neck Cancer Survivors: Longitudinal Findings from the Head and Neck 5000 Prospective Clinical Cohort

Lookup NU author(s): Professor Linda Sharp, Laura-Jayne Watson, Dr Liya Lu, Dr Joanne Patterson



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2023 by the authors. Cancer-related fatigue (CRF) is a common side-effect of cancer and its treatments. For head and neck cancer (HNC), CRF may exacerbate the symptom burden and poor quality-of-life. Using data from the Head and Neck 5000 prospective clinical cohort, we investigated clinically important CRF over a year post-diagnosis, assessing temporal trends, CRF by HNC site and treatment received, and subgroups at higher risk of CRF. Recruitment was undertaken in 2011–2014. Socio-demographic and clinical data, and patient-reported CRF (EORTC QLQ-C30 fatigue subscale score ≥39 of a possible 100) were collected at baseline (pre-treatment) and 4- and 12- months post-baseline. Mixed-effects logistic multivariable regression was used to investigate time trends, compare cancer sites and treatment groups, and identify associations between clinical, socio-demographic and lifestyle variables and CRF. At baseline, 27.8% of 2847 patients scored in the range for clinically important CRF. This was 44.7% at 4 months and 29.6% at 12 months. In the multivariable model, after adjusting for time-point, the odds of having CRF over 12 months were significantly increased in females and current smokers; those with stage 3/4 disease, comorbidities and multimodal treatment; and those who had depression at baseline. The high prevalence of clinically important CRF indicates the need for additional interventions and supports for affected HNC patients. These findings also identified patient subgroups towards whom such interventions could be targeted.

Publication metadata

Author(s): Sharp L, Watson L-J, Lu L, Harding S, Hurley K, Thomas SJ, Patterson JM

Publication type: Article

Publication status: Published

Journal: Cancers

Year: 2023

Volume: 15

Issue: 19

Online publication date: 05/10/2023

Acceptance date: 30/09/2023

Date deposited: 08/11/2023

ISSN (electronic): 2072-6694

Publisher: MDPI


DOI: 10.3390/cancers15194864


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Funder referenceFunder name
Above and Beyond
Cancer Research UK
National Institute for Health and Care Research (NIHR)
NIHR Senior Investigator award
University Hospitals Bristol and Weston Research Capability Funding