Prevalence of Pain- Cancer Pts - Systematic Review

Prevalence of Pain in Patients With Cancer: A Systematic Review of the Past 40 Years Posted 10/29/2007

MHJ van den Beuken-van Everdingen; JM de Rijke; AG Kessels; HC Schouten; M van Kleef; J Patijn

Abstract Background: Despite the abundant literature on this topic, accurate prevalence estimates of pain in cancer patients are not available. We investigated the prevalence of pain in cancer patients according to the different disease stages and types of cancer.

Patients and methods: A systematic review of the literature was conducted. An instrument especially designed for judging prevalence studies on their methodological quality was used. Methodologically acceptable articles were used in the meta-analyses.

Results: Fifty-two studies were used in the meta-analysis. Pooled prevalence rates of pain were calculated for four subgroups: (i) studies including patients after curative treatment, 33% [95% confidence interval (CI) 21% to 46%]; (ii) studies including patients under anticancer treatment: 59% (CI 44% to 73%); (iii) studies including patients characterised as advanced/metastatic/terminal disease, 64% (CI 58% to 69%) and (iii) studies including patients at all disease stages, 53% (CI 43% to 63%).

Of the patients with pain more than one-third graded their pain as moderate or severe. Pooled prevalence of pain was > 50% in all cancer types with the highest prevalence in head/neck cancer patients (70%; 95% CI 51% to 88%).

Conclusion The pooled data from 52 articles showed that pain was prevalent in cancer patients: 64% in patients with metastatic or advanced stage disease, 59% in patients on anticancer treatment and 33% in patients after curative treatment. More than one-third of the patients with pain in the reviewed articles graded their pain as moderate or severe. Despite the clear WHO recommendations, cancer pain still is a major problem. The increasing number of cancer survivors who live to an advanced age means that it is of paramount importance to reduce the prevalence of pain at all stages of the disease process.

Ann Oncol 18(9) 2007

Thanks to Medscape, October 2007

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