Prevalence of cancer-related fatigue after treatment in patients with non-metastatic gastrointestinal cancers

BACKGROUND: Cancer-related fatigue (CRF) is a prevalent and distressing symptom that persist long after treatment, significantly diminishing the quality of life in cancer survivors-particularly those with gastrointestinal (GI) malignancies. OBJECTIVE: This study aimed to evaluate the prevalence and severity of CRF one year after treatment and to examine its associations with demographic and clinical characteristics in patients with non-metastatic GI cancers. METHODS: In this observational cross-sectional study, 103 patients with non-metastatic GI cancers who had completed treatment at least 12 months prior were recruited from Besat Hospital and Mahdieh Radiotherapy Center in Hamadan between 2020 and 2021 using a census sampling method. Fatigue was assessed with the Brief Fatigue Inventory (BFI-10), and associations with demographic variables, cancer stage, tumor site, and treatment type were analyzed using SPSS version 26. RESULTS: The mean age of participants was 60.43 ± 10.52 years, and the average disease duration was 3.28 ± 0.45 years. The mean fatigue score was 5.63 ± 2.61 on a 0-10 scale. Most participants were male (51.5%), married (85.4%), had less than a high school education (49.5%), and were self-employed (57.5%). Rectal cancer was the most common diagnosis (53.4%), with the majority of patients diagnosed at stage III (68%). Fatigue severity was classified as mild in 26.2%, moderate in 34.0%, and severe in 39.8% of patients. Higher fatigue severity was significantly associated with female gender, advanced disease stage (stage III), and lower educational level (P < 0.05). No significant associations were found with age, disease duration, marital status, occupation, tumor location, or treatment type. CONCLUSION: A considerable proportion of patients with non-metastatic GI cancers continue to experience moderate to severe CRF one year post-treatment. The greater fatigue burden among women and those with advanced-stage disease underscores the importance of routine fatigue assessment and targeted supportive care interventions for these at-risk populations.