Pain in long‐term survivors of childhood cancer: A systematic review of the current state of knowledge and a call to action from the Children's Oncology Group

Pain in long‐term survivors of childhood cancer: A systematic review of the current state of knowledge and a call to action from the Children's Oncology Group

Survivors of childhood cancer may be at risk of experiencing pain, and a systematic review would advance our understanding of pain in this population. The objective of this study was to describe: 1) the prevalence of pain in survivors of childhood cancer, 2) methods of pain measurement, 3) associati...

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Bibliographic Details
Published in:Cancer Vol. 127; no. 1; pp. 35 - 44
Main Authors: Schulte, Fiona S. M., Patton, Michaela, Alberts, Nicole M., Kunin‐Batson, Alicia, Olson‐Bullis, Barbara A., Forbes, Caitlin, Russell, K. Brooke, Neville, Alexandra, Heathcote, Lauren C., Karlson, Cynthia W., Racine, Nicole M., Charnock, Courtney, Hocking, Matthew C., Banerjee, Pia, Tutelman, Perri R., Noel, Melanie, Krull, Kevin R.
Format: Journal Article
Language:English
Published: United States Wiley Subscription Services, Inc 01-01-2021
Subjects:
Bias
Cancer
Cancer Survivors - statistics & numerical data
Children
Chronic pain
Evaluation
Female
Health risks
Humans
Male
neoplasms
Oncology
Pain
Pain - etiology
Pain - pathology
pediatrics
psycho‐oncology
Quality
Reviews
Risk
Risk Assessment
Survival
survivorship
Systematic review
survivorship
pain
neoplasms
psycho-oncology
pediatrics
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Summary:Survivors of childhood cancer may be at risk of experiencing pain, and a systematic review would advance our understanding of pain in this population. The objective of this study was to describe: 1) the prevalence of pain in survivors of childhood cancer, 2) methods of pain measurement, 3) associations between pain and biopsychosocial factors, and 4) recommendations for future research. Data sources for the study were articles published from January 1990 to August 2019 identified in the PubMed, PsycINFO, EMBASE, and Web of Science data bases. Eligible studies included: 1) original research, 2) quantitative assessments of pain, 3) articles published in English, 4) cancers diagnosed between birth and age 21 years, 5) survivors at 5 years from diagnosis and/or at 2 years after therapy completion, and 6) a sample size >20. Seventy‐three articles were included in the final review. Risk of bias was considered using the Cochrane risk of bias tool. The quality of evidence was evaluated according to Grading of Recommendations Assessment Development and Evaluation (GRADE) criteria. Common measures of pain were items created by the authors for the purpose of the study (45.2%) or health‐related quality‐of‐life/health status questionnaires (42.5%). Pain was present in from 4.3% to 75% of survivors across studies. Three studies investigated chronic pain according the definition in the International Classification of Diseases. The findings indicated that survivors of childhood cancer are at higher risk of experiencing pain compared with controls. Fatigue was consistently associated with pain, females reported more pain than males, and other factors related to pain will require stronger evidence. Theoretically grounded, multidimensional measurements of pain are absent from the literature. Survivors of childhood cancer are at higher risk of experiencing pain compared with controls. Future research is urgently needed to discern the true prevalence of pain among this vulnerable population and to develop interventions to enhance the quality of survivorship.
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ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.33289