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Characterizing pain in long-term survivors of childhood cancer

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Abstract

Many long-term survivors of childhood cancer (LTSCC), individuals at least 5 years post-diagnosis or 2 years post-treatment, experience late- and long-term effects from their treatments, including pain. Yet, pain is poorly understood among LTSCC. The current study aimed to (1a) describe rates and multiple dimensions of pain; (1b) identify patterns of chronic pain; and (2) test correlates of chronic pain in LTSCC. Survivors (n = 140; 48.6% male, Mage = 17.3 years (range = 8–25)) were recruited from across Canada. Between 2017 and 2019, participants completed the Pain Questionnaire, Pain Catastrophizing Scale, Pediatric Quality of Life Inventory, Patient-Reported Outcome Measurement Information System (PROMIS)–Pain Interference, Anxiety, and Depression scales, Child Posttraumatic Stress Scale, the Posttraumatic Stress Disorder Checklist for the DSM-V, and the Cancer Worry Scale.

Results

Twenty-six percent of LTSCC reported experiencing chronic pain. Exploratory cluster analysis showed 20% of survivors had moderate to severe chronic pain based on measures of pain intensity and interference. The combination of higher posttraumatic stress symptoms, older current age, more pain catastrophizing, and sex (being female) significantly predicted the presence of chronic pain in logistic regression, χ2 (4, N = 107) = 28.10, p < .001. Higher pain catastrophizing (OR = 1.09; 95% CI = 1.02–1.16), older current age (OR = 1.20; 95% CI = 1.07–1.34), and higher posttraumatic stress (OR = 1.92; 95% CI = 1.01–3.63) were significant predictors of chronic pain. LTSCC should be screened for the presence and magnitude of chronic pain during long-term follow-up visits so appropriate interventions can be offered and implemented. Future research should investigate pain interventions tailored for this population.

Relevance

Findings support regular screening for the presence and magnitude of chronic pain in survivors of childhood cancer in long-term follow-up care.

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Data availability

The data from the current study is available upon reasonable request to the corresponding author.

Code availability

The syntax used in analyses is available upon reasonable request to the corresponding author.

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Acknowledgements

Study data were collected and managed using REDCap electronic data capture tools hosted at the University of Calgary Clinical Research Unit. REDCap (Research Electronic Data Capture) is a secure, web-based application designed to support data capture for research studies, providing (1) an intuitive interface for validated data entry; (2) audit trails for tracking data manipulation and export procedures; (3) automated export procedures for seamless data downloads to common statistical packages; and (4) procedures for importing data from external sources.

Funding

The current study was supported by the Arnie Charbonneau Cancer Institute and Daniel Family Foundation.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Calgary, Calgary, Canada

    Michaela Patton & Melanie Noel

  2. The Hospital for Sick Children, Toronto, Canada

    Victoria J. Forster

  3. Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C3, Canada

    Caitlin Forbes, Mehak Stokoe, Linda E. Carlson, Kathryn A. Birnie & Fiona Schulte

  4. Long Term Survivor’s Clinic, Alberta Children’s Hospital, Calgary, Canada

    Kathleen Reynolds

  5. Department of Family Medicine, University of Calgary, Calgary, Canada

    Kathleen Reynolds

  6. Hematology, Oncology, and Bone Marrow Transplant Program, Alberta Children’s Hospital, Calgary, Canada

    Fiona Schulte

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  1. Michaela Patton
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Contributions

Conceptualization: Michaela Patton, Fiona Schulte; methodology: Michaela Patton, Fiona Schulte, Melanie Noel; formal analysis and investigation: Michaela Patton; writing—original draft preparation: Michaela Patton; writing—review and editing: Victoria Forster, Mehak Stokoe, Caitlin Forbes, Melanie Noel, Linda Carlson, Kathleen Reynolds, Kathryn Birnie; funding acquisition: Fiona Schulte; resources: Caitlin Forbes, Mehak Stokoe; supervision: Fiona Schulte.

Corresponding author

Correspondence to Fiona Schulte.

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Ethics approval

Ethics approval was obtained via the local institutional review board (HREBA.CC-17-0059).

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For participants under 18 years old, caregivers provided consent for their child’s participation. Participants under 18 years provided assent. Participants over 18 years provided consent.

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No identifying information was included in the publication.

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The authors declare no competing interests.

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Patton, M., Forster, V.J., Forbes, C. et al. Characterizing pain in long-term survivors of childhood cancer. Support Care Cancer 30, 295–303 (2022). https://doi.org/10.1007/s00520-021-06386-4

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