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A new report finds about one in three cancer survivors (34.6%) reported having chronic pain, representing nearly 5.4 million cancer survivors in the United States. The report, appearing as a Research Letter in JAMA Oncology, finds one in six survivors (16%), representing about 2.5 million people in the U.S., reported suffering from high impact chronic pain that restricts daily functioning. Those rates are about double the rates in the general population.

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. Nevertheless, there is a paucity of information regarding the prevalence of, and risk factors for, the development of chronic pain among cancer survivors.

To gain a better understanding of the epidemiology of pain in cancer survivors and help inform future health care priorities and policies, investigators led by Changchuan (Charles) Jiang, MD, MPH, of Mount Sinai St. Luke’s and Mount Sinai West, New York, with researchers from Memorial Sloan-Kettering Cancer Center, University of Virginia, and the American Cancer Society investigated the prevalence of chronic pain among cancer survivors in the United States using data from the National Health Interview Survey (2016-2017). The survey collects information related to chronic pain (pain on most days or every day in the past six months) and high impact chronic pain (chronic pain limiting life or work activities on most days or every day in the past 6 months).

Overall, 1,648 of the 4,526 cancer survivors identified in the survey (34.6%) reported having chronic pain; 768 of the survivors (16.1%) reported having high impact chronic pain. Applied to the nation as a whole, those rates equal approximately 5.39 million and 2.51 million cancer survivors, respectively, in the U.S.

Time since diagnosis was not significantly associated with the prevalence of either chronic pain, but a  higher prevalence of chronic and high impact chronic pain was reported among survivors with less than a high school education (39.2% for chronic pain and 18.5% for high impact chronic pain), low household income (44.6% and 22.8%, respectively), public insurance among those aged 18-64 years (43.6% and 27.1%, respectively), or no paid employment (38.5% and 20.4%, respectively).

“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 Xuesong Han, PhD, American Cancer Society investigator and co-author of the report. “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.”

Article: Prevalence of Chronic Pain and High-Impact Chronic Pain in Cancer Survivors in the United States; Jiang et al.; JAMA Oncology; Published online June 20, 2019; doi:10.1001/jamaoncol.2019.1439