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Annals of Oncology Advance Access published online on October 14, 2005
Annals of Oncology, doi:10.1093/annonc/mdi407
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© 2005 European Society for Medical Oncology
Received April 29, 2005
Revised July 20, 2005
Accepted August 2, 2005

Original article

A comparison between long-term survivors of Hodgkin's disease and their siblings on fatigue level and factors predicting for increased fatigue

A. K. Ng 1*, S. Li 2, C. Recklitis 3, D. Neuberg 2, S. Chakrabarti 1, B. Silver 1, and L. Diller 3

1 Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA
2 Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
3 Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

* To whom correspondence should be addressed.
A. K. Ng, E-mail: ang{at}lroc.harvard.edu


  Abstract

Purpose: To compare the level of fatigue in survivors of Hodgkin's disease and their siblings, and to explore factors associated with increased fatigue.

Methods: Survivors of Hodgkin's disease 5 years or more from diagnosis and their siblings completed a questionnaire study. Fatigue level was measured using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) instrument, with lower scores reflecting increased fatigue. Multiple regression models were used to identify factors associated with fatigue level in the two populations.

Results: Five hundred and eleven survivors (median age 44 years; range 16-82) and 224 siblings (median age 44 years; range 16-79) returned the completed questionnaire. The response rates were 61% and 58%, respectively. Compared with siblings, survivors were significantly more likely to report the presence of cardiac disease (26% versus 16%; P = 0.001) and hypothyroidism (65% versus 3%; P <0.001), and had a significantly lower mean FACIT-F score (40.7 and 42.2; P = 0.05). On multivariable analysis, factors significantly associated with increased fatigue in survivors were reports of cardiac disease (P <0.001), psychiatric condition (P <0.001), history of tobacco use (P = 0.004) and low exercise frequency (P = 0.03). For siblings, the only independent factor associated with increased fatigue was low exercise frequency (P = 0.03).

Conclusions: Survivors of Hodgkin's disease were more fatigued than their siblings. The difference was modest but statistically significant. The significant association between fatigue and cardiac disease suggests the importance of screening for underlying cardiac dysfunction in survivors with symptoms of fatigue. The association between fatigue and smoking history may be due to exacerbation of late medical complications of Hodgkin's disease by tobacco use.

Keywords: cancer survivors; fatigue; Hodgkin's disease; late effects.
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