Understanding pain and quality of life in paediatric cancer survivors: a systematic review with a focus on early survivorship

Abstract

Background: pain is a common but often under-recognized clinical feature among children and young people (CYP) cancer survivors. This systematic review aimed to examine the prevalence of acute and chronic pain in 5–24-year-old cancer survivors, explore associated biopsychosocial comorbidities and evaluate the psychometric properties of pain assessment tools used with this population.

Methods: this review provides a conceptual replication to a review published in 2020 by Schulte et al. by updating and purposefully narrowing the review population to CYP (5–24 y) to better capture their pain experience. We updated the search from Schulte et al., extending the search period up to October 2024 across 5 databases.

Results: our independent search identified 18 studies, with only 1 new paper published since Schulte et al., 2020. Overall, CYP cancer survivors reported a higher prevalence of pain than the general population, with females experiencing higher levels than males, consistent with broader chronic pain literature. Fatigue, depression, and anxiety were common comorbidities, and pain substantially impacted quality of life. Key limitations included the use of unvalidated questionnaires; inconsistent definitions of chronic pain and lack of patient stratification based on diagnoses, age and treatment protocol. Moreover, data were aggregated, and we were unable to extract information from early survivorship.

Conclusions: there is a critical need for more rigorous research on pain in CYP cancer survivors. Specifically, gathering data on pain experienced during the immediate posttreatment completion phase of cancer care, an area currently underrepresented in the literature, will provide valuable insights into patients’ pain trajectories.

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Identifiers

ORCID for Christina Liossi: orcid.org/0000-0003-0627-6377

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