The Impact of Cancer-Related Fatigue on HRQOL in Survivors of Childhood Cancer: A DCCSS LATER Study

Adriaan Penson*, Iris Walraven, on behalf of the Dutch LATER study group, Ewald Bronkhorst, Heleen Maurice-Stam, Martha A. Grootenhuis, Margriet Van der Heiden-Van der Loo, Wim J.E. Tissing, Helena J.H. Van der Pal, Andrica C.H. De Vries, Dorine Bresters, Cécile Ronckers, Marry M. Van den Heuvel, Sebastian J.C.M.M. Neggers, Birgitta A.B. Versluys, Marloes Louwerens, Saskia M.F. Pluijm, Leontien C.M. Kremer, Nicole Blijlevens, Eline Van Dulmen-Den BroederHans Knoop, Jacqueline Loonen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)
15 Downloads (Pure)


Background: Early detection and management of late effects of treatment and their impact on health-related quality of life (HRQOL) has become a key goal of childhood cancer survivorship care. One of the most prevalent late effects is chronic fatigue (CF). The current study aimed to investigate the association between CF and HRQOL in a nationwide cohort of CCS. Methods: Participants were included from the Dutch Childhood Cancer Survivor Study (DCCSS) LATER cohort, a nationwide cohort of CCS. Participants completed the Checklist Individual Strength (CIS) to indicate CF (CIS fatigue severity subscale ≥ 35 and duration of symptoms ≥6 months) and the Short Form-36 (SF-36) and TNO (Netherlands Organization for Applied Scientific Research) and AZL (Leiden University Medical Centre) Adult’s Health-Related Quality of Life questionnaire (TAAQOL) as measures for HRQOL. Differences in mean HRQOL domain scores between CF and non-CF participants were investigated using independent samples t-tests and ANCOVA to adjust for age and sex. The association between CF and impaired HRQOL (scoring ≥ 2 SD below the population norm) was investigated using logistic regression analyses, adjusting for confounders. Results: A total of 1695 participants were included in the study. Mean HRQOL domain scores were significantly lower in participants with CF. In addition, CF was associated with impaired HRQOL on all of the domains (except physical functioning) with adjusted odds ratios ranging from 2.1 (95% CI 1.3–3.4; sexuality domain) to 30.4 (95% CI 16.4–56.2; vitality domain). Conclusions: CF is associated with impaired HRQOL, urging for the screening and regular monitoring of fatigue, and developing possible preventative programs and interventions.

Original languageEnglish
Article number2851
Issue number12
Publication statusPublished - 1 Jun 2022

Bibliographical note

Funding Information:
Acknowledgments: The authors would like to thank all cancer survivors participating in the study and the VOKK and VOX for their contribution to the DCCSS LATER study. The authors thank Iridi Stollman for her contribution to the design and illustration of the Figures and the authors thank the complete LATER Study Group for their contribution to the study. The DCCSS LATER program was funded by KIKA/ODAS (grant 171 ‘DCOG LATER program’) and the Dutch Cancer Society (grant KUN 2014-6985).

Funding Information:
Funding: The DCCSS LATER program was supported by ‘stichting Kinderen Kankervrij’ (KIKA)&ODAS (grant 171 ‘DCOG LATER program’) and the Dutch Cancer Society (grant KUN 2014-6985).

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


Dive into the research topics of 'The Impact of Cancer-Related Fatigue on HRQOL in Survivors of Childhood Cancer: A DCCSS LATER Study'. Together they form a unique fingerprint.

Cite this