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Pain prevalence and characteristics in survivors of solid cancers: a systematic review and meta-analysis

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Abstract

Purpose

The latest systematic review on the prevalence of pain in cancer survivors was published 5 years ago. The current review aims to provide an extended overview on the prevalence of pain, pain mechanisms, pain characteristics, and assessment methods in cancer survivors.

Methods

A systematic research was conducted on 17th of April 2020 using MEDLINE, Embase, Scopus, Web of Science, and Cochrane looking at studies from 2014 to 2020. Studies had to report pain prevalence rates in cancer survivors with a solid tumor who finished curative treatment at least 3 months ago. Methodological quality was assessed by two independent reviewers using the Joanna Briggs Institute quality appraisal tool. Characteristics of the included studies, participants and reported pain prevalence rates were extracted. The reported prevalence rates of the individual studies were pooled within a meta-analysis. Meta-regressions were performed to identify possible determinants of the pooled pain prevalence.

Results

After deduplication, 7300 articles were screened, after which 38 were included in the meta-analysis. Risk of bias was rated low in 26 articles and moderate in 12 articles. The pooled pain prevalence was 47% (95%CI 39–55), with a heterogeneity of 98.99%.

Conclusion

This meta-analysis suggests that nearly half of cancer survivors report pain after completing curative treatment at least 3 months ago. However, substantial unexplained heterogeneity warrants cautious interpretation of these results. Meta-regression using cancer type, treatment location, pain measurement, and follow-up time as a covariate could not explain influencing factors explaining the high heterogeneity.

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Abbreviations

EORTC:

European Organization of Research and Treatment of Cancer

QoL:

Quality of life

NRS:

Numeric rating scale

IASP:

International Association for the Study of Pain

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

RCT:

Randomized controlled trial

CIPN:

Chemotherapy-Induced Peripheral Neuropathy

VH:

Vincent Haenen

TdB:

Tom De Baerdemaecker

ME:

Margaux Evenepoel

ADG:

An De Groef

JBI:

Joanna Briggs Institute

VAS:

Visual analogue scale

BPI:

Brief Pain Inventory

NPSI:

Neuropathic Pain Symptom Inventory

EORTC-QLQ-C30:

European Organization for Research and Treatment for Cancer Quality of Life Questionnaire

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Funding

This research was supported by the Flanders Research Foundation [grant number 12R1719N].

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Authors and Affiliations

  1. Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium

    Vincent Haenen, Margaux Evenepoel, Mira Meeus, Lore Dams, Sophie Van Dijck, Elien Van der Gucht, Tessa De Vrieze, Thijs Vande Vyvere & An De Groef

  2. Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium

    Vincent Haenen, Tom De Baerdemaecker, Nele Devoogdt, Lore Dams, Elien Van der Gucht, Tessa De Vrieze & An De Groef

  3. Pain in Motion International Research Group, www.paininmotion.be, Brussels, Belgium

    Vincent Haenen, Mira Meeus, Lore Dams, Sophie Van Dijck, Elien Van der Gucht, Thijs Vande Vyvere & An De Groef

  4. Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium

    Mira Meeus

  5. Department of Vascular Surgery and Department of Physical Medicine and Rehabilitation, Center for Lymphoedema, UZ Leuven-University Hospitals Leuven, Leuven, Belgium

    Nele Devoogdt

  6. Department of Cardiovascular Sciences, Section Anaesthesiology & Algology, KU Leuven, University of Leuven, Leuven, Belgium

    Bart Morlion

  7. The Leuven Centre for Algology and Pain Management, University Hospitals Leuven, Leuven, Belgium

    Bart Morlion

  8. Department of Radiology, Antwerp University Hospital, Antwerp, Belgium

    Thijs Vande Vyvere

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  1. Vincent Haenen
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Contributions

Vincent Haenen and Margaux Evenepoel were responsible for the study conception and design. Study preparation, data collection and analysis were performed by Vincent Haenen and Margaux Evenepoel. The first version of the manuscript was written by Vincent Haenen and all authors reviewed previous versions. The final manuscript was read and approved by all authors.

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Correspondence to An De Groef.

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All authors have completed the ICMJE uniform disclosure form (available on request from the corresponding author) and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work. B. Morlion has served as a consultant for Reckitt-Benekiser, Grunenthal, Pfizer, GSK, and as a speaker for Grunenthal, Krka, GSK Belgium.

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Haenen, V., Evenepoel, M., De Baerdemaecker, T. et al. Pain prevalence and characteristics in survivors of solid cancers: a systematic review and meta-analysis. Support Care Cancer 31, 85 (2023). https://doi.org/10.1007/s00520-022-07491-8

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