Incidence and Influencing Factors of Pain Crisis in Cancer Patients: A Systematic Review and Meta-Analysis.
Fengjuan Wang, Huifen Tong, Limei Gao et al.
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In 30 seconds
This systematic review and meta-analysis assessed the incidence of pain crisis and associated factors among people with cancer. Seven studies including 1865 patients were analysed; the pooled incidence was 37%. Factors significantly associated with pain crisis included bone metastasis (OR = 3.91), radiotherapy and chemotherapy (OR = 3.23), social support (OR = 0.88), age (OR = 0.92), anxiety, and depression. Anxiety associations increased across severity categories, while both mild and moderate depression were significant predictors. The findings identify clinical and emotional factors that may help inform risk assessment, but do not establish causation.
Key findings
- Across seven studies involving 1865 cancer patients, the pooled incidence of pain crisis was 37%.
- Bone metastasis (OR = 3.91) and radiotherapy and chemotherapy (OR = 3.23) were significant influencing factors.
- Anxiety was associated with pain crisis at mild (OR = 8.00), moderate (OR = 9.15), and severe (OR = 10.99) levels.
- Social support (OR = 0.88), age (OR = 0.92), and mild and moderate depression (OR = 6.54 and OR = 6.46) were significant factors.
Why it matters
Pain crisis was common in the included cancer populations, and the review links risk with disease-related, treatment-related, and emotional factors. These findings support attention to psychological state and social support alongside clinical risk factors when assessing patients. Because the evidence synthesizes associations, it can guide risk awareness but cannot show that changing any one factor will prevent pain crisis.
What to keep in mind
The meta-analysis included only seven studies, and the abstract does not report study-level design or follow-up details. The pooled associations therefore do not establish causation.