title: Musculoskeletal pain is associated with a long-term increased risk of cancer and cardiovascular-related mortality.
abstract: OBJECTIVE
  To test the hypothesis that individuals with regional and widespread pain disorders have an increased risk of mortality.
  
  
  METHODS
  We conducted a prospective cohort study of 4515 adults. Subjects were an age- and sex-stratified sample who had participated in a population study of pain occurrence during 1996. Based on those reports subjects were classified as having no pain, regional pain or widespread pain. All subjects were identified on the National Health Service Central Register and followed up until April 2005, a total of 8.2 yrs, at which time information was obtained on vital status, and if applicable, date and cause of death. The relationship between pain status and subsequent death is expressed as mortality rate ratios with 95% CIs, adjusted for age, gender, ethnicity and practice.
  
  
  RESULTS
  A total of 35.2% reported regional pain and 16.9% satisfied criteria for widespread pain. In comparison with those without pain, there was a 20% and 30% increased risk of dying over the follow-up period among subjects with regional and widespread pain, respectively. The specific causes of death in excess were cancer and cardiovascular disease. In addition, the mortality risk from both cancer and cardiovascular deaths was found to increase as the number of pain sites that subjects reported increased.
  
  
  CONCLUSIONS
  This study supports a previous observation that persons with regional and widespread pain are at an increased risk of cancer death. Possible mechanisms should be explored.
authors.affiliation: Arthritis Research Campaign Epidemiology Unit, Epidemiology Research Group, Research School of Translational Medicine, University of Manchester, Manchester, UK. john.mcbeth@manchester.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: McBeth
authors.forename: D P
authors.initials: DP
authors.lastname: Symmons
authors.forename: A J
authors.initials: AJ
authors.lastname: Silman
authors.forename: T
authors.initials: T
authors.lastname: Allison
authors.forename: R
authors.initials: R
authors.lastname: Webb
authors.forename: T
authors.initials: T
authors.lastname: Brammah
authors.forename: G J
authors.initials: GJ
authors.lastname: Macfarlane
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D005356:Fibromyalgia / Q000401:mortality* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D010147:Pain Measurement / Q000379:methods; D011204:Poverty Areas; D055815:Young Adult