title: Pain in patients attending a specialist cancer service: prevalence and association with emotional distress.
abstract: BACKGROUND
  We know little about how many outpatients of a modern cancer center suffer from clinically significant unrelieved pain and the characteristics of these patients to guide better care.
  
  
  OBJECTIVE
  To determine the prevalence of clinically significant pain (CSP) in the outpatients of a regional cancer center and the association with distress and other variables.
  
  
  METHODS
  A secondary analysis of cross-sectional, self-reported and clinical data from 2768 patients reattending selected clinics of a regional National Health Service cancer center in the U.K. Pain was measured using the pain severity scale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, emotional distress was measured by the Hospital Anxiety and Depression Scale, and demographic and clinical data were taken from medical records.
  
  
  RESULTS
  Fifty-four percent (95% confidence interval [CI] 52-56) of patients reported pain at least "a little" in the previous week and 18% (95% CI 17-20) at least "quite a bit" (CSP). The strongest independent associations of CSP were active disease (odds ratio [OR] 1.95, 95% CI 1.5-2.5) and emotional distress (OR 4.8, 95% CI 4-6).
  
  
  CONCLUSIONS
  CSP is surprisingly common in outpatients of specialist cancer services, and it is strongly and independently associated with emotional distress. Better symptom management should consider pain and distress together.
authors.affiliation: Psychological Medicine Research, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: O'Connor
authors.forename: Jim
authors.initials: J
authors.lastname: Weir
authors.forename: Isabella
authors.initials: I
authors.lastname: Butcher
authors.forename: Annet
authors.initials: A
authors.lastname: Kleiboer
authors.forename: Gordon
authors.initials: G
authors.lastname: Murray
authors.forename: Neelom
authors.initials: N
authors.lastname: Sharma
authors.forename: Parvez
authors.initials: P
authors.lastname: Thekkumpurath
authors.forename: Jane
authors.initials: J
authors.lastname: Walker
authors.forename: Marie
authors.initials: M
authors.lastname: Fallon
authors.forename: Dawn J
authors.initials: DJ
authors.lastname: Storey
authors.forename: Michael
authors.initials: M
authors.lastname: Sharpe
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D010146:Pain / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D013315:Stress, Psychological / Q000453:epidemiology*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult