Profiles of Fatigue and Psychological Symptoms in Long-Term Childhood, Adolescent, and Young Adult Cancer Survivors—The NOR-CAYACS Study

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2024-11-25 DOI:10.1002/cam4.70425

Wei H. Deng, Hanne C. Lie, Ellen Ruud, Jon H. Loge, Cecilie E. Kiserud, Corina S. Rueegg

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Abstract

Introduction

Long-term childhood, adolescent, and young adult cancer survivors (CAYACS) are at risk of fatigue and psychological problems. However, their interactions remain largely unexplored. Understanding how they cluster can inform treatment and person-centered follow-up care. We aimed to identify and describe profiles of co-occurring fatigue and psychological symptoms and investigate their associations with health-related quality of life (HRQOL) in CAYACS.

Methods

NOR-CAYACS (The Norwegian Childhood, Adolescents and Young Adult Cancer Survivors study) was a nationwide survey involving adult survivors of any childhood cancer (aged < 19 years at diagnosis) and selected young adult cancers (breast and colorectal cancers, non-Hodgkin lymphoma, leukemias, and malignant melanomas, aged 19–39 years at diagnosis) identified through the Cancer Registry of Norway. We included 1893 survivors aged ≥ 18 years, ≥ 5 years since diagnosis. We performed latent profile analysis with six continuous outcomes: physical and mental fatigue, depression, anxiety, post-traumatic stress symptoms, and fear of recurrence.

Results

We identified an overall “Low” (64%), a “Moderate fatigue/high anxiety” (18%), a “High fatigue/moderate distress” (13%), and an overall “High” (5%) symptom burden profile. The “High” profile exhibited lowest physical- and mental-HRQOL with T-scores −9.8 (95% confidence interval [95% CI]: −12.5, −7.1) and −25.0 (95% CI: −26.7, −23.3) compared to the “Low” profile.

Conclusion

We identified four profiles, two characterized by high fatigue and two near normative fatigue levels, each with different psychological symptom burden. Greater symptom burden corresponded to lower HRQOL, with high fatigue profiles showing lower physical HRQOL. These profiles help identify at-risk individuals and allow for targeting interventions and follow-up care to survivors' unique constellation of symptoms.

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儿童、青少年和青年长期癌症幸存者的疲劳和心理症状特征--NOR-CAYACS 研究

导言儿童、青少年和青年癌症长期幸存者（CAYACS）有可能出现疲劳和心理问题。然而，它们之间的相互作用在很大程度上仍未得到研究。了解它们如何相互影响可以为治疗和以人为本的后续护理提供依据。我们的目的是识别和描述 CAYACS 中同时出现的疲劳和心理症状的特征，并研究它们与健康相关生活质量（HRQOL）的关系。方法 NOR-CAYACS（挪威儿童、青少年和年轻成人癌症幸存者研究）是一项全国性调查，涉及通过挪威癌症登记处确认的任何儿童癌症（确诊时年龄为19岁）和部分年轻成人癌症（乳腺癌和结直肠癌、非霍奇金淋巴瘤、白血病和恶性黑色素瘤，确诊时年龄为19-39岁）的成年幸存者。我们纳入了 1893 名年龄≥ 18 岁、确诊后≥ 5 年的幸存者。我们对六种连续结果进行了潜在特征分析：身心疲劳、抑郁、焦虑、创伤后应激症状和对复发的恐惧。结果我们确定了总体 "低"（64%）、"中度疲劳/高度焦虑"（18%）、"高度疲劳/中度痛苦"（13%）和总体 "高"（5%）的症状负担特征。与 "低 "症状特征相比，"高 "症状特征表现出最低的身体和精神HRQOL，T值分别为-9.8（95% 置信区间[95% CI]：-12.5，-7.1）和-25.0（95% CI：-26.7，-23.3）。结论我们发现了四种情况，两种以高度疲劳为特征，两种接近正常疲劳水平，每种情况都有不同的心理症状负担。症状负担越重，HRQOL 越低，高疲劳度特征显示出较低的身体 HRQOL。这些特征有助于识别高危人群，并针对幸存者的独特症状组合进行有针对性的干预和后续护理。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.