Prevalence of Fatigue in Patients with Cancer: A Systematic Review and Meta-Analysis.

Background Fatigue is a particularly common and troubling symptom that has a negative impact on quality of life throughout all phases of treatment and stages of the illness among patients with cancer. The aim of this meta-analysis is to examine the present status of fatigue prevalence in patients with cancer. Method The following databases were searched: PubMed, MEDLINE, EMBASE, PsycINFO, Cochrane Library, from inception up to February 2020. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I 2 ) statistics. Result A total of one hundred and twenty-nine studies (N=71568) published between 1993 and 2020 met the inclusion criteria. The overall prevalence of fatigue was 49% (34947/71656 participants, 95% CI 45% to 53%) with significant heterogeneity between studies (p 2 = 0.0000, I2 = 98.88%). Subgroup analyses shows that the prevalence of fatigue related to type of cancer were ranged from 26.2% in patients with gynaecological cancer to 56.3% in studies that included mixed types of cancer. In patient with advanced cancer stage reported highest prevalence of Fatigue 60.6%. Fatigue prevalence rates were 62% during treatment and 51% mixed treatment status. The prevalence of fatigue decreased from 64% in studies published from 1996-2000 to 43% in studies published from 2016-2020. Meta-regression identified female gender as a significant moderator for higher prevalence of fatigue, whereas mean age is not associated with fatigue. Conclusion This meta-analysis highlights the importance of developing optimal monitoring strategies to reduce fatigue and improve the quality of life of cancer patients.