Prevalence of Neuropathic Pain in Cancer Patients: Pooled Estimates From a Systematic Review of Published Literature and Results From a Survey Conducted in 50 Italian Palliative Care Centers

Abstract

ContextBecause of the increasing body of literature on neuropathic cancer pain (NCP), an accurate estimate of its prevalence requires recurring updates. ObjectivesTo provide this estimate using information from a systematic review and a survey. MethodsUsing MEDLINE, Embase, and a previous review, we searched for studies published up to 2014 reporting data on NCP prevalence in adult cancer populations. Pooled prevalence rates from observational prospective studies were computed. The association between NCP prevalence and possible predictors was investigated for oncology and palliative settings. Prevalence rates were extracted from a questionnaire answered by 137 physicians working in 50 Italian centers of palliative care. Estimates from studies conducted in palliative settings and from the experts were analyzed separately and eventually pooled with an informative Bayesian random-effect model. ResultsTwenty-nine observational studies were identified. The overall pooled prevalence was 31.2%, with high heterogeneity; similar figures were observed when oncology and palliative settings were individually considered. A slightly higher prevalence of NCP was detected for hospice/inpatients as compared to outpatients, in both settings. The mean NCP prevalence reported by the survey experts was 44.2%; the pooled Bayesian estimate for the palliative setting corresponded to 43.0% (95% CI: 40.0–46.0). The subgroup with the lowest heterogeneity and where the literature and experts' estimates were closest is hospice/inpatients, with a pooled Bayesian prevalence rate of 34.9% (95% CI: 29.9–41.0). ConclusionThe systematic review and the survey suggest that more than one in three patients with cancer pain also experiences NCP.