Chronic Pain Reported in 1 in 3 Cancer Survivors

About one in three cancer survivors live with chronic pain, according to a research letter published in JAMA Oncology.

There are an estimated 15.5 million cancer survivors living in the United States, and that number is expected to grow to 26.1 million by 2040, the report states.

Chronic pain is one of the most common long-term effects of cancer treatment and has been linked with an impaired quality of life, lower adherence to treatment, and higher health care costs,” the study authors wrote. “Nevertheless, there is a paucity of information regarding the prevalence of, and risk factors for, the development of chronic pain among cancer survivors.”

The researchers used the 2016-2017 National Health Interview Survey to identify adult cancer survivors. The survey defines chronic pain as pain almost every day or every day for the past six months, and defines high-impact chronic pain (HICP) as six-month history of chronic pain that impedes life or work activities almost every day or every day. Patients who received a diagnosis before they turned 18 or who were only diagnosed with nonmelanoma skin cancer were excluded from the review.

One-third of Survivors Report Chronic Pain

The analysis included 4,526 cancer survivors, of whom 1,648 (34.6%) reported chronic pain and 768 (16.1%) reported HICP. When adjusting for the total cancer survivor population, this translates to roughly 5.39 million and 2.51 million cancer survivors nationwide with chronic pain and HICP, respectively. The prevalence of chronic pain or HICP did not vary based on age, sex, marital status, or region, but patients with less than a high school education were more likely to report chronic pain (39.2%) or HICP (18.5%), as were patients with low household income (44.6% and 22.8%, respectively), public insurance (among patients aged 18-64 years; 43.6% and 27.1%, respectively), or no paid employment (38.5% and 20.4%, respectively). In adjusted analyses, chronic pain was more prevalent among survivors of bone (54.0%), kidney (52.3%), throat-pharynx (47.9%), and uterine (44.5%) cancers

“Because socioeconomic status and employment are associated with insurance coverage and access to care in the United States, the patterns of chronic pain that we observed in cancer survivors may be explained by barriers to cancer care and pain management as well as by the type and extent of cancer treatment received,” said study author Xuesong Han, PhD, an American Cancer Society investigator, in a press release. “The prevalence of chronic pain and high impact chronic pain among cancer survivors in our study was almost double that in the general population, suggesting there are important unmet needs in the large and growing community of people with a history of cancer.”

In their report, the researchers conclude that cancer survivors are more likely than the general population to suffer from chronic pain and HICP, “thereby suggesting the presence of important unmet needs in the large and growing cancer survivorship community.”