The pattern of increased risk of fatigue among women which was so clearly demonstrated in population-based studies of healthy individuals is not so obvious in cancer-related fatigue. Of nine studies identified which assessed the relationship, five found no difference between men and women (Hickok et al. 1996; Smets et al. 1998a; Glaus 1998; Donnelly et al. 1995; Stone et al. 1999), whilst the remaining four (Vogelzang et al. 1997; Smets et al. 1998b; Loge et al. 1999; Akechi et al. 1999) showed that women had more fatigue than men. The key difference between papers which appear to show a difference and those which do not is the disease stage or time from treatment—those that found a difference in rates between men and women tended to have taken samples with earlier disease or ‘survivors’ in whom the disease had remitted. It may be that with less aggressive or remitted disease, the pattern of fatigue becomes closer to that of the general population.
The pattern of fatigue in cancer according to age is confusing. There might be an expectation that younger cancer patients suffer less fatigue, but Hickok et al. (1996) found a U-shaped distribution of fatigue in cancer patients according to age, with fatigue symptoms at their highest in relatively young adults (aged less than 50) and the over 70s. Glaus (1998) found a slightly more complex biphasic relationship, with younger patients having more affective symptoms of fatigue whilst the older group had more physical symptoms of fatigue. Two other studies reported a relationship between age and fatigue—Loge et al. (1999) found that older patients were more fatigued and Vogelzang et al. (1997) found younger patients were more fatigued. The remaining studies showed no relationship (Andrykowski et al. 1998; Smets et al. 1998a; Stone et al 1999; Cimprich 1999; Hann et al. 1999).
One other remaining sociodemographic characteristic was widely studied, namely educational status. Here there appears to be a consistent association, with most studies reporting greater fatigue in the less well educated (Irvine et al. 1994; Mast 1998; Loge et al. 1999) although, as ever, there are exceptions, with one study (Akechi et al. 1999) describing the opposite relationship.
The pattern of fatigue in cancer according to age is confusing. There might be an expectation that younger cancer patients suffer less fatigue, but Hickok et al. (1996) found a U-shaped distribution of fatigue in cancer patients according to age, with fatigue symptoms at their highest in relatively young adults (aged less than 50) and the over 70s. Glaus (1998) found a slightly more complex biphasic relationship, with younger patients having more affective symptoms of fatigue whilst the older group had more physical symptoms of fatigue. Two other studies reported a relationship between age and fatigue—Loge et al. (1999) found that older patients were more fatigued and Vogelzang et al. (1997) found younger patients were more fatigued. The remaining studies showed no relationship (Andrykowski et al. 1998; Smets et al. 1998a; Stone et al 1999; Cimprich 1999; Hann et al. 1999).
One other remaining sociodemographic characteristic was widely studied, namely educational status. Here there appears to be a consistent association, with most studies reporting greater fatigue in the less well educated (Irvine et al. 1994; Mast 1998; Loge et al. 1999) although, as ever, there are exceptions, with one study (Akechi et al. 1999) describing the opposite relationship.
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