Supportive Care in Cancer

, Volume 24, Issue 6, pp 2565–2574 | Cite as

Is it possible to detect an improvement in cancer pain management? A comparison of two Norwegian cross-sectional studies conducted 5 years apart

  • Morten Thronæs
  • Sunil X. Raj
  • Cinzia Brunelli
  • Sigrun Saur Almberg
  • Ola Magne Vagnildhaug
  • Susanna Bruheim
  • Birgit Helgheim
  • Stein Kaasa
  • Anne Kari Knudsen
Original Article



Cancer pain (CP) management is challenging. In recent years, efforts were undertaken to achieve better CP management, e.g. clinical research, new treatment modalities, development of guidelines, education and focus on implementation. The aim of the present study was to compare the prevalence and characteristics of pain and breakthrough pain (BTP) between cross-sectional studies conducted in 2008 and 2014. It was hypothesized that an improvement in pain control would be observed the years in between.


Two cross-sectional studies were conducted where adult cancer patients answered questions from Brief Pain Inventory and the Alberta Breakthrough Pain Assessment Tool for cancer patients. Physicians reported socio-demographic and medical data. Regression models were applied for analysis.


In total, 168 inpatients, 92 in 2008 and 76 in 2014, and 675 outpatients, 301 in 2008 and 374 in 2014, were included. The patient characteristics of the samples were comparable. Prevalence of CP among inpatients was 55 % in 2008 and 53 % in 2014, and among outpatients, 39 and 35 %, respectively. Inpatients reported average pain intensity (0–10 numerical rating scale, NRS) of 3.60 (standard deviation, SD 1.84) (2008) and 4.08 (SD 2.11) (2014); prevalence of BTP was 52 % (2008) and 41 % (2014). For outpatients, average pain intensity was 3.60 (SD 2.04) (2008) and 3.86 (SD 2.20) (2014); prevalence of BTP was 43 % (2008) and 37 % (2014). None of the differences were statistically significant.


Unexpectedly, no improvement in pain control was observed. Efforts are still needed to improve cancer pain management.


Cancer Pain management BTP Implementation Breakthrough pain Cross-sectional study Prevalence 


Disclosure and acknowledgement

The research group was given a grant from the Cancer Foundation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway, to conduct this study. BC received training grant from the Floriani Foundation—Milan (del.CDA 22/11/12).

Special thanks to Professor Dagny Faksvåg Haugen for support and advice during the analysis and writing of the manuscript and to Jorunn Brekke Fjeldheim for including patients at Aalesund Hospital in this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Morten Thronæs
    • 1
    • 2
  • Sunil X. Raj
    • 1
    • 2
  • Cinzia Brunelli
    • 1
    • 3
  • Sigrun Saur Almberg
    • 2
  • Ola Magne Vagnildhaug
    • 1
    • 2
  • Susanna Bruheim
    • 1
  • Birgit Helgheim
    • 1
  • Stein Kaasa
    • 1
    • 2
  • Anne Kari Knudsen
    • 1
    • 2
  1. 1.European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), St. Olavs HospitalTrondheim University HospitalTrondheimNorway
  2. 2.Cancer ClinicSt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
  3. 3.Palliative Care, Pain therapy and Rehabilitation UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly

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