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3 - Cancer pain epidemiology

from SECTION II - EPIDEMIOLOGY AND SYNDROMES

Published online by Cambridge University Press:  06 July 2010

By
IRENE J. HIGGINSON  and
FLISS MURTAGH
Edited by
Eduardo D. Bruera  and
Russell K. Portenoy
IRENE J. HIGGINSON
Affiliation:
King's College London
FLISS MURTAGH
Affiliation:
King's College London
Eduardo D. Bruera
Affiliation:
University of Texas, Houston
Russell K. Portenoy
Affiliation:
Albert Einstein College of Medicine, New York
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Summary

Introduction

Cancer pain afflicts millions of people worldwide every year, yet it can be well or completely controlled in 80%–90% of patients. Exactly how many of the estimated 6.6 million people worldwide who died from cancer last year experienced pain at any one time is difficult to ascertain. The reasons for this are discussed in the following text. Nevertheless, in spite of the major advances in pain control over the past 15 years, cancer-related pain continues to be a major international public health problem.

Although pain is recognized as an extremely common symptom in patients with cancer, studies to date show a wide variation in the reported prevalence. A systematic review of 19 studies recording the prevalence of pain in cancer found pain reported in 35%–96% of patients. Three main factors influence this variation:

  1. Difficulty in making generalizations to different health care settings or different patient groups because of variation in the design of prevalence studies

  2. Inherent difficulties in assessing the presence or absence of pain, particularly because no one “gold standard” assessment system exists, exacerbated by attempts to grade the severity of cancer pain in a variety of ways

  3. Difficulty in defining the type of pain, because pain associated with cancer has features of both chronic and acute pain and can be either the direct or indirect result of the cancer

Pain and cancer are not synonymous. Evaluation of pain in advanced cancer is primarily clinical and is based on pattern recognition.

Type
Chapter
Information
Cancer Pain
Assessment and Management
 , pp. 37 - 52
Publisher: Cambridge University Press
Print publication year: 2009

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