Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 28;25(1):1394.
doi: 10.1186/s12885-025-14829-y.

Validation of the cancer fatigue scale (CFS) in a UK population

C Robinson  1 , G Feder  2 , A L Huntley  3 , J Ramsay  1 , D Varsani  1 , D Gangahar  1 , M Kröz  4   5
Affiliations

Validation of the cancer fatigue scale (CFS) in a UK population

C Robinson et al. BMC Cancer. .

Abstract

Background: Cancer-related fatigue is one of the most common symptoms in patients with cancer. Fatigue reduces health-related quality of life. The Cancer Fatigue Scale (CFS) is a brief instrument that captures the multidimensional nature of fatigue with robust validity. The original scale was developed/validated with Japanese cancer patients. It was our aim to report the psychometric properties of an English translation of the CFS.

Methods: This cross-sectional study was conducted between February-October 2008 in London, UK. Three groups were recruited: cancer patients (index group), diabetic patients (chronic disease control group), and a healthy control group. All participants completed a questionnaire on recruitment and a subset were retested at 2-8 weeks. Reliability was assessed with analysis of internal consistency (Cronbach's alpha), homogeneity (item-total correlations) and test-retest reliability. Construct validity was assessed with inter-subscale correlations. To assess convergent validity, the correlations between the CFS and FNS, EORTC - QLQ C30, and HADS were examined with Spearman Rank correlation coefficients. The discriminant validity was determined by the known group method.

Results: 160 participants were recruited: 60 cancer and 50 diabetes patients, and 50 healthy patients. Cronbach's alphas for the total scale and all three subscales (range 0.83,0.94) were all above the 0.70 criterion suggested for group comparisons thus the CFS showed excellent internal consistency. Homogeneity measures all fulfilled the 0.20 criterion (range 0.53-0.84). Combining the three groups, all test-retest correlations for the CFS and its subscales were above 0.7. Physical and affective subscales showed 100% scaling success. Both scores and sub-scores for the CFS correlated positively (p < 0.001) with FNS and HADS depression and anxiety subscales. The CFS correlated positively (p < 0.001) with all but one item of the EORTC-QLQ C30.

Conclusions: This evaluation of the measurement properties of the CFS-English shows that it is a reliable and valid tool for assessing key dimensions of cancer-related fatigue.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the local NHS research ethics committee (appropriate to Queen Mary University of London) and we certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards Competing interests: The authors declare no competing interests. Conflict of interest: The authors declare that they have no competing interests.

References

    1. Paice JA, Ferrell B. The management of cancer pain. CA Cancer J Clin. 2011;61(3):157–82. - PubMed
    1. Wood JM, Chapman K, Eilers J. Tools for assessing nausea, vomiting, and retching. Cancer Nurs. 2011;34(1):E14–24. - PubMed
    1. Stone P, Richardson A, Ream E, et al. Cancer-related fatigue: inevitable, unimportant, and untreatable? Results of a multi-centre patient survey. Ann Oncol. 2000;11(8):971–5. - PubMed
    1. Berger AM, Mooney K, Alvarez-Perez A, et al. Cancer-Related fatigue, version 2.2015. J Natl Compr Canc Netw. 2015;13(8):1012–39. - PMC - PubMed
    1. Visser MR, van Lanschot J, van der Velden F. Quality of life in newly diagnosed cancer patients waiting for surgery is. J Surg Oncol. 2006;93(7):571–7. - PubMed

Publication types

LinkOut - more resources