Pain risk is high among adult survivors of childhood cancer

  • Karlson CW & al.
  • Cancer
  • 30 Mar 2020

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Almost 30% of adult survivors of childhood cancer reported severe pain more than 20 years after their initial diagnosis.

Why this matters

  • Regular pain screenings in survivors of childhood cancer could reduce the long-term effect of pain.

Study design

  • 10,012 adult survivors and 3173 siblings from the Childhood Cancer Survivor Study.
  • Follow-ups at 2 times, 5 years apart.
  • Funding: National Cancer Institute.

Key results

  • Compared with siblings, survivors were more likely to report (relative risks; 95% CIs):
    • Severe or very severe pain: 1.28 (1.07-1.54).
    • Quite a bit or extreme pain interference: 1.26 (1.06-1.51).
    • Moderate or severe recurrent pain: 1.23 (1.02-1.49).
  • At the second follow-up, compared with their siblings, survivors reported more:
    • Symptoms of depression: 11.9% clinical vs 7.3% clinical (P<.001>
    • Symptoms of anxiety: 7.8% clinical vs 5.7% clinical (P<.001>
    • Total analgesic use: 11.7% vs 9.4% (P=.01).
  • Compared with survivors of leukemia, survivors of sarcomas/bone tumors had higher relative risks (95% CIs) for:
    • Severe late-occurrence pain: 1.47 (1.45-1.49).
    • Quite a bit or extreme pain interference: 1.38 (1.35-1.41). 
    • Moderate or severe recurrent pain: 1.33 (1.32-1.34).
  • Older age at diagnosis, female sex, and minority race categorization are among the risk factors for increased risk for pain.

Limitations

  • Study design may have led to an underestimated effect of pain.