Pain in long-term adult survivors of childhood cancers and their siblings: A report from the Childhood Cancer Survivor Study

• Type of Material: Article
• Authors: Qian Lu, University of Houston; Kevin R. Krull, St. Jude Children's Hospital; Wendy Leisenring, Fred Hutchinson Cancer Research Center; Jason E. Owen, Loma Linda University; Toana Kawashima, Fred Hutchinson Cancer Research Center; Jennie C. I. Tsao, University of California Los Angeles; Bradley Zebrack, University of Michigan; Ann Mertens, Emory University; Gregory T. Armstrong, St. Jude Children's Hospital; Marilyn Stovall, University of Texas MD Anderson Cancer Center; Leslie L. Robison, St. Jude Children's Hospital; Lonnie K. Zeltzer, University of California Los Angeles
• Language: English
• Date: 2011-11-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.pain.2011.08.006
• Title of Journal or Parent Work: PAIN
• ISSN: 0304-3959
• Volume: 152
• Issue: 11
• Start Page: 2616
• End Page: 2624
• Grant/Funding Information: CCSS is supported by a grant from the National Cancer Institute (U24 CA55727, PI: L.L. Robison) of the National Institutes of Health and by support to St. Jude Children’s Research Hospital from the American Lebanese Syrian Associated Charities (ALSAC) and a Cancer Center Support (CORE) grant (CA21765).; Support has also been provided by the Lance Armstrong Foundation (G 00-12-076-02, PI: L Zeltzer), the American Cancer Society (ROG-02-238-01, PI: L Zeltzer), and American Cancer Society (MRSGT-10-011-01-CPPB, PI: Q. Lu).
• Keywords: Anesthesiology; Pain attribution; Neurosciences; QUALITY-OF-LIFE; Clinical Neurology; PREVALENCE; COHORT; Life Sciences & Biomedicine; ETHNIC DISPARITIES; COMMUNITY-DWELLING ADULTS; Neurosciences & Neurology; Self-reported pain; SYMPTOMS; Risk factors; CARE; Science & Technology; ADAPTATION; POPULATION; Long-term adult survivors of childhood cancer; CHILDREN
• Research Categories: Psychology, Physiological; Health Sciences, Oncology; Biology, Neuroscience

Abstract

Little is known about pain among long-term adult survivors of childhood cancers. The study investigated pain prevalence in this population compared with sibling controls and examined pain-related risk factors. Three self-reported pain outcomes including pain conditions, prescription analgesics used, and pain attributed to cancer and treatment were assessed among 10,397 cancer survivors and 3034 sibling controls from the Childhood Cancer Survivor Study. Pain conditions (pain/abnormal sensation, migraines, and other headaches) were reported by 12.3%, 15.5%, and 20.5% of survivors, respectively; 16.7% of survivors reported use of prescription analgesics, and 21% attributed pain to cancer and treatment. Risks of reporting pain conditions and using prescription analgesics were higher among survivors than siblings, adjusting for sociodemographic factors. Younger age at diagnosis and a history of non-Hodgkin lymphoma, Wilms tumor, or neuroblastoma (compared to leukemia) were associated with greater risk of reporting pain conditions. A history of bone cancer or soft tissue sarcoma (compared to leukemia) was associated with greater risks of using prescription analgesics and cancer-related pain attribution. Non-brain-directed scatter irradiation was associated with elevated risk for migraines and cancer-related pain attribution. Female gender and lower educational attainment were associated with increased reports of all 3 pain outcomes; minority status, unemployment, and being single were associated with greater risks for reporting pain conditions. These findings contribute to the understanding of pain and associated risk factors among adult survivors of childhood cancer and suggest areas of focus for pain intervention.