406P - The association between ICD-10 criteria for cancer-related fatigue and symptom distress among cancer patients during treatment in different geograp...

Date 20 December 2015
Event ESMO Asia 2015 Congress
Session Poster presentation 2
Topics Supportive Measures
Presenter Yun-Jen Chou
Citation Annals of Oncology (2015) 26 (suppl_9): 111-124. 10.1093/annonc/mdv531
Authors Y. Chou1, S.C. Shun2, R. Hsieh3, M. Lee4, W.T. Huang5, K. Yeh6, C.S. Chang7, S.C. Lin8
  • 1Nursing, National Taiwan University NTU, College of Medicine, 10051 - Taipei/TW
  • 2Nursing, National Taiwan University NTU, College of Medicine, Taipei/TW
  • 3Hematology And Oncology, Mackay Memorial Hospital, Taipei/TW
  • 4Hematology And Oncology, Chia Yi Christian Hospital, Chiayi/TW
  • 5Hematology And Oncology, Liouying Chi-Mei Hospital, Tainan/TW
  • 6Oncology, National Taiwan University Hospital, Taipei/TW
  • 7Hematology-oncology, Changhua Christian Hospital Cancer Research Center, Changhua City/TW
  • 8Hematology And Oncology, Far Eastern Memorial Hospital, New Taipei City/TW



Cancer-related fatigue (CRF) is the most common symptom in cancer patients especially in cancer patients during treatments. The International Classification of Diseases 10th Revision (ICD-10) Criteria for CRF is a common diagnostic criterion to identify the patients with CRF. However, it is a need for a simple way for assessing CRF cases in the clinical settings. Therefore, the aim of this study was to explore the occurrence of CRF and examine association between ICD-10 for CRF and Symptom distress in northern, central and south in Taiwan.


A national survey with cross-sectional study design was used. Patients who were receiving active treatment were recruited from 20 hospitals in Northern (n = 557) and Central and Southern (n = 484) Taiwan. A structured questionnaire was used to explore patients' demographic and disease characteristics and symptom distress. Each symptom distress was assessed by one item with 11-point Likert-type Scale. The CRF were assessed by ICD-10 for CRF. Receiver operating characteristic (ROC) curve was used to evaluate the symptom distress in the top 3 rank of symptom in screening for CRF cases based on the ICD-10.


About 38.4% and 43.2% patients complained of generalized weakness or limb heaviness in patients in Northern, and Central and Southern Taiwan, respectively. In overall, the occurrence of CRF was 25.6% based on ICD-10 CRF criteria, and 21.0% and 31.0% in Northern, and central and Southern Taiwan, respectively. The top 3 rank of symptoms distress were fatigue, insomnia and pain in two groups. In ROC curve analysis, the cutoff point of fatigue was set at 3.5 point (AUC = 0.831) for identifying CRF cases for overall and two groups in Taiwan.


This study found that the higher occurrence of CRF in central and southern Taiwan, but the cutoff point are not different for identifying the CRF cases. The fatigue distress with 3.5 point had a good discrimination to recognize the CRF cases in cancer patients during treatments. However, insomnia and pain were without a good discrimination for CRF. Therefore, the healthcare providers could use the score of fatigue distress to identify the CRF cases in the busy clinical practice efficiently.

Clinical trial identification


All authors have declared no conflicts of interest.