-
Tytuł:
-
Pain and functional outcomes in adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort study.
-
Autorzy:
-
Tonning Olsson, Ingrid
Alberts, Nicole M.
Li, Chenghong
Ehrhardt, Matthew J.
Mulrooney, Daniel A.
Liu, Wei
Pappo, Alberto S.
Bishop, Michael W.
Anghelescu, Doralina L.
Srivastava, Deokumar
Robison, Leslie L.
Hudson, Melissa M.
Ness, Kirsten K.
Krull, Kevin R.
Brinkman, Tara M.
-
Temat:
-
CHILDHOOD cancer
CANCER pain
CANCER survivors
PAIN management
COHORT analysis
PHYSICAL mobility
PAIN
-
Źródło:
-
Cancer (0008543X); May2021, Vol. 127 Issue 10, p1679-1689, 11p
-
Background: Although survivors of childhood cancer are at risk of chronic pain, the impact of pain on daily functioning is not well understood. Methods: A total of 2836 survivors (mean age, 32.2 years [SD, 8.5 years]; mean time since diagnosis, 23.7 years [SD, 8.2 years]) and 343 noncancer community controls (mean age, 35.5 years [SD, 10.2 years]) underwent comprehensive medical, neurocognitive, and physical performance assessments, and completed measures of pain, health‐related quality of life (HRQOL), and social functioning. Multinomial logistic regression models, using odds ratios and 95% confidence intervals (95% CIs), examined associations between diagnosis, treatment exposures, chronic health conditions, and pain. Relative risks (RRs) between pain and neurocognition, physical performance, social functioning, and HRQOL were examined using modified Poisson regression. Results: Approximately 18% of survivors (95% CI, 16.1%‐18.9%) versus 8% of controls (95% CI, 5.0%‐10.9%) reported moderate to very severe pain with moderate to extreme daily interference (P <.001). Severe and life‐threatening chronic health conditions were associated with an increased likelihood of pain with interference (odds ratio, 2.03; 95% CI, 1.62‐2.54). Pain with daily interference was found to be associated with an increased risk of impaired neurocognition (attention: RR, 1.88 [95% CI, 1.46‐2.41]; and memory: RR, 1.65 [95% CI, 1.25‐2.17]), physical functioning (aerobic capacity: RR, 2.29 [95% CI, 1.84‐2.84]; and mobility: RR, 1.71 [95% CI, 1.42‐2.06]), social functioning (inability to hold a job and/or attend school: RR, 4.46 [95% CI, 3.45‐5.76]; and assistance with routine and/or personal care needs: RR, 5.64 [95% CI, 3.92‐8.10]), and HRQOL (physical: RR, 6.34 [95% CI, 5.04‐7.98]; and emotional: RR, 2.83 [95% CI, 2.28‐3.50]). Conclusions: Survivors of childhood cancer are at risk of pain and associated functional impairments. Survivors should be screened routinely for pain and interventions targeting pain interference are needed. Adult survivors of childhood cancer are at an increased risk of moderate to very severe pain compared with community controls. In long‐term survivors, pain significantly interferes with multiple aspects of daily functioning. [ABSTRACT FROM AUTHOR]
Copyright of Cancer (0008543X) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)