• M H J van den Beuken-van Everdingen, J M de Rijke, A G Kessels, H C Schouten, M van Kleef, and J Patijn.
• Pain Management and Research Centre, University Hospital Maastricht, Masstricht, The Netherlands. mvdb@adcc.azm.nl
• Ann. Oncol. 2007 Sep 1;18(9):1437-49.

BackgroundDespite the abundant literature on this topic, accurate prevalence estimates of pain in cancer patients are not available. We investigated the prevalence of pain in cancer patients according to the different disease stages and types of cancer.Patients And MethodsA systematic review of the literature was conducted. An instrument especially designed for judging prevalence studies on their methodological quality was used. Methodologically acceptable articles were used in the meta-analyses.ResultsFifty-two studies were used in the meta-analysis. Pooled prevalence rates of pain were calculated for four subgroups: (i) studies including patients after curative treatment, 33% [95% confidence interval (CI) 21% to 46%]; (ii) studies including patients under anticancer treatment: 59% (CI 44% to 73%); (iii) studies including patients characterised as advanced/metastatic/terminal disease, 64% (CI 58% to 69%) and (iii) studies including patients at all disease stages, 53% (CI 43% to 63%). Of the patients with pain more than one-third graded their pain as moderate or severe. Pooled prevalence of pain was >50% in all cancer types with the highest prevalence in head/neck cancer patients (70%; 95% CI 51% to 88%).ConclusionDespite the clear World Health Organisation recommendations, cancer pain still is a major problem.

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