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Annals of Oncology Advance Access originally published online on February 24, 2009
Annals of Oncology 2009 20(8):1420-1433; doi:10.1093/annonc/mdp001
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

oncology practice

Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes

H. Breivik1,*, N. Cherny2, B. Collett3, F. de Conno4, M. Filbet5, A. J. Foubert6, R. Cohen7 and L. Dow7

1 Faculty of Medicine, University of Oslo and Department of Anaesthesiology, Rikshospitalet University Hospital, Oslo, Norway
2 Cancer Pain and Palliative Medicine Services, Shaare Zedek Medical Center, Jerusalem, Israel
3 The Pain Management Service, University Hospitals of Leicester NHS Trust, Leicester, UK
4 Rehabilitation and Palliative Care Unit, National Cancer Institute (Foundation), Milan, Italy
5 Centre de soins palliatifs, Centre hospitalier Lyon sud, HCL CHU de Lyon, Pierre Benite, France
6 Departement Gezondheidszorg, Erasmushogeschool, Brussels, Belgium
7 Mundipharma International Ltd, Cambridge Science Park, Cambridge, UK

* Correspondence to: Prof. H. Breivik, Faculty of Medicine and Rikshospitalet University Hospital, University of Oslo, Department of Anaesthesiology Rikshospitalet, 0027 Oslo, Norway. Tel: +47-23073691; Fax: +47-23073690; E-mail: harald.breivik{at}medisin.uio.no

Background: The European Pain in Cancer survey sought to increase understanding of cancer-related pain and treatment across Europe.

Patients and methods: Patients with all stages of cancer participated in a two-phase telephone survey conducted in 11 European countries and Israel in 2006–2007. The survey screened for patients experiencing pain at least weekly, then randomly selected adult patients with pain of at least moderate intensity occurring several times per week for the last month completed a detailed attitudinal questionnaire.

Results: Of 5084 adult patients contacted, 56% suffered moderate-to-severe pain at least monthly. Of 573 patients randomly selected for the second survey phase, 77% were receiving prescription-only analgesics, with 41% taking strong opioids either alone or with other drugs for cancer-related pain. Of those prescribed analgesics, 63% experienced breakthrough pain. In all, 69% reported pain-related difficulties with everyday activities; however, 50% believed that their quality of life was not considered a priority in their overall care by their health care professional.

Conclusions: Across Europe and Israel, treatment of cancer pain is suboptimal. Pain and pain relief should be considered integral to the diagnosis and treatment of cancer; management guidelines should be revised to improve pain control in patients with cancer.

Key words: cancer pain, chronic pain, Europe, impact of pain, survey, treatment of pain

Received for publication May 29, 2008. Revision received October 21, 2008. Accepted for publication December 22, 2008.


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