Medline ® Abstracts for References 1,2
of 'Assessment of cancer pain'
The epidemiology of cancer pain.
Goudas LC, Bloch R, Gialeli-Goudas M, Lau J, Carr DB
Cancer Invest. 2005;23(2):182.
We identified 28 epidemiological surveys by applying a sensitive search in Medline and CancerLit databases, supplemented by hand searches. Only two surveys enrolled more than 10,000 patients with cancer. The remaining were hospital or clinic-based surveys of at most a few hundred patients. Fourteen surveys were conducted in the United States. The majority of the remaining studies were conducted in Europe (Finland, France, Germany, UK/Ireland). No single survey identified a prevalence of any type of pain below 14%. The prevalence of pain reported in these surveys varies with the specific type of pain (e.g., breakthrough pain) and/or population studied. Based on these surveys an aggregate statement could not be deduced regarding the correlation between the occurrence of pain and patient factors, disease characteristics, the setting in which care is provided (e.g., primary care or specialized oncology or pain treatment clinics), or specific treatments directed towards the underlying disease and its associated pain. However, these surveys suggest that a significant number of patients with cancer worldwide will, during the course of their disease, experience pain that requires medical and/or other treatment.
Department of Anesthesia, Tufts-New England Medical Center, Boston, Massachusetts, USA. email@example.com
Prevalence of pain in patients with cancer: a systematic review of the past 40 years.
van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J
Ann Oncol. 2007;18(9):1437. Epub 2007 Mar 12.
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: Despite the clear World Health Organisation recommendations, cancer pain still is a major problem.
Pain Management and Research Centre, University Hospital Maastricht, Masstricht, The Netherlands. firstname.lastname@example.org