Pain Prevalence During Cancer Treatment: A Systematic Review and Meta-Analysis

Abstract

Context: Pain is one of the most complex and prevalent symptoms in the cancer population. Despite the protective role of acute cancer-related pain, it is also an important predictor for the likelihood of developing chronic pain after cancer treatment.

Objectives: Since the last systematic review on pain prevalence rates during cancer treatment dates already from 2016, the aim of the present systematic review was to provide an overview of pain prevalence rates during cancer treatment since this previous review.

Methods: A systematic search of the literature, including studies between 2014 and 2020, was conducted using the databases Pubmed, Embase, Scopus, Web of Science and Cochrane. Studies reporting pain prevalence rates during or within three months after curative cancer treatment was included. Title/abstract and full-text was screened double-blinded, followed by independent evaluation of the risk of bias. All prevalence rates were pooled within meta-analyses and a meta-regression was performed to clarify the amount of heterogeneity.

Results: Of the 9052 studies, 12 studies were included in the meta-analysis of which 10 included breast cancer and two lung cancer patients. The pooled pain prevalence rate was 40% (95%CI 0.29-0.51), with a heterogeneity of 96%. Out of the meta-regression, only the covariate "method of pain measurement" significantly clarified the heterogeneity (P < 0.05), resulting in a residual heterogeneity of 94.88%.

Conclusion: Five years after the last systematic review published on this topic, pain is still very prevalent during cancer treatment. However, the pain prevalence rates were also very heterogeneous. These two findings emphasize the need for further research on the development of adequate pain assessment and pain management approaches during cancer treatment.

Keywords: Cancer pain; meta-analysis; meta-regression; systematic review.