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Palliative Medicine
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0269216309103125v1
23/4/295    most recent
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*Cancer
*Pain
*Palliative Care
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Article

Classification of pain in cancer patients – a systematic literature review

AK Knudsen1*, N Aass2, R Fainsinger3, A Caraceni4, P Klepstad5, M Jordhøy6, MJ Hjermstad7, and S Kaasa8

1 Pain and Palliation Research Group and Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, 3.etg. Gastro sør, Trondheim University Hospital, Trondheim
2 Pain and Palliation Research Group and Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, 3.etg. Gastro sør, Trondheim University Hospital, Trondheim; Division of Cancer Medicine and Radiotherapy, Rikshospitalet University Hospital, Oslo; The Cancer Center, Ullevål University Hospital, Oslo
3 Division of Palliative Care Medicine, University of Alberta, 217 – Health Services Centre, 1090 Youville Drive West, Room Edmonton, Edmonton, AB
4 Palliative Care Unit, Fondazione IRCCS, Istituto Nazionale Dei Tumori, Milano
5 Pain and Palliation Research Group and Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, 3.etg. Gastro sør, Trondheim University Hospital, Trondheim; Department of Anaesthesiology and Emergency Medicine, Intensive Care Unit, St. Olav University Hospital, NO-7006 Trondheim
6 Cancer Unit, Department of Internal Medicine, Innlandet Hospital Trust, Kyrre Greppsgt 11, Gjøvik
7 Pain and Palliation Research Group and Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, 3.etg. Gastro sør, Trondheim University Hospital, Trondheim; The Cancer Center, Ullevål University Hospital, Oslo
8 Pain and Palliation Research Group and Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, 3.etg. Gastro sør, Trondheim University Hospital, Trondheim; Palliative Medicine Unit, Department of Oncology, Trondheim University Hospital, Trondheim

* To whom correspondence should be addressed.


  Abstract

One of the aims of the European Palliative Care Research Collaborative (EPCRC) is to achieve consensus on a classification system for cancer pain. We performed a systematic literature review to identify existing classification systems and domains/items used to classify cancer patients with pain. In a systematic search in the databases Medline and Embase, covering 1986–2006, 692 hits were obtained. 92 papers were evaluated to address pain classification. Six standardised classification systems were identified; three of them systematically developed and partially validated. Both pain characteristics and patient characteristics relevant for cancer pain classification were included in the classification systems. All but one of the standardised systems aim at predicting treatment response or adequacy of treatment. Several domains and items used to describe cancer pain but not formally described as part of a classification system were also identified and systematised. The existing approaches to pain classification in cancer patients are different, mostly not thoroughly validated, and none is widely applied. An internationally accepted classification system for cancer pain could improve research and cancer pain management. This systematic review suggests a need for developing an international consensus on how to classify pain in cancer patients.

Key Words: cancer, classification, pain, palliative care, symptoms, systematic review

First published on March 13, 2009, doi:10.1177/0269216309103125

Palliative Medicine 2009;23:295.

A more recent version of this article appeared on June 1, 2009

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