title: Prevalence of persistent pain after breast cancer treatment by detection mode among participants in population-based screening programs.
abstract: To date, the study of the risks and benefits of breast cancer screening has not included the onset of persistent pain after breast cancer treatment within the context of population-based screening programs. Our purpose was to investigate the prevalence of persistent pain and associated factors in women diagnosed with breast cancer (screening or interval) in the context of a population-based breast cancer screening program in Spain.
  
  
  
  A total of 1,057 women participating in a population-based breast cancer screening program were diagnosed with breast cancer between 2000 and 2008. The women were treated surgically and followed-up to 2013. The risk of developing persistent pain was estimated through multivariate logistic regression analysis.
  
  
  
  Breast cancer was detected during routine screening in 732 women (69.3 %) and emerged as an interval cancer between two screening rounds in 325 (30.7 %). Persistent pain was present in 118 women (11.3 %). Women diagnosed through routine screening reported a higher prevalence of persistent pain (12.9 %) than those with interval cancers (7.8 %)(P < 0.05). Multivariate logistic regression analysis identified two other variables associated with persistent pain: having a Charlson index > =2 (Odds Ratio [OR]: 4.5 95 % Confidence Interval [CI]: 2.1-9.5) versus no comorbidities, and having undergone an axillary lymph node dissection (OR: 2.0 95 % CI: 1.0-4.0) versus sentinel lymph node biopsy.
  
  
  
  The prevalence of persistent pain was relatively low. The detection mode was not related to the onset of persistent pain. The factors associated with persistent pain were a Charlson index > =2 and the performance of axillary lymph node dissection. Women treated for breast cancer are at risk for developing persistent pain regardless of the detection mode, especially those with comorbidities and those who have undergone axillary lymph node dissection.
authors.affiliation: Department of Epidemiology and Evaluation, IMIM-Hospital del Mar, Research Network on Health Services in Chronic Diseases (REDISSEC), Passeig Marítim 25-29, Barcelona, 08003, Spain. aromero@imim.es.
authors.forename: Anabel
authors.identifier: 0000-0001-8017-1501
authors.initials: A
authors.lastname: Romero
authors.affiliation: Department of Epidemiology and Evaluation, IMIM-Hospital del Mar, Research Network on Health Services in Chronic Diseases (REDISSEC), Passeig Marítim 25-29, Barcelona, 08003, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Torà-Rocamora
authors.affiliation: Clinical Epidemiology and Cancer Screening, Corporació Sanitària Parc Taulí-UAB, Research Network on Health Services in Chronic Diseases (REDISSEC), Sabadell, Spain.
authors.forename: Marisa
authors.initials: M
authors.lastname: Baré
authors.affiliation: General Directorate of Health Care Programmes, Canary Islands Health Service, Las Palmas de Gran Canaria, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Barata
authors.affiliation: Department of Epidemiology and Evaluation, IMIM-Hospital del Mar, Research Network on Health Services in Chronic Diseases (REDISSEC), Passeig Marítim 25-29, Barcelona, 08003, Spain.|Agency for Health Quality and Assessment of Catalonia (AQuAS), Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain.
authors.forename: Laia
authors.initials: L
authors.lastname: Domingo
authors.affiliation: Department of Radiology, Hospital de Santa Caterina, Salt, Girona, Spain.
authors.forename: Joana
authors.initials: J
authors.lastname: Ferrer
authors.affiliation: Clinical Epidemiology and Cancer Screening, Corporació Sanitària Parc Taulí-UAB, Research Network on Health Services in Chronic Diseases (REDISSEC), Sabadell, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Torà
authors.affiliation: Department of Epidemiology and Evaluation, IMIM-Hospital del Mar, Research Network on Health Services in Chronic Diseases (REDISSEC), Passeig Marítim 25-29, Barcelona, 08003, Spain.
authors.forename: Mercè
authors.initials: M
authors.lastname: Comas
authors.affiliation: General Directorate of Health Care Programmes, Canary Islands Health Service, Las Palmas de Gran Canaria, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Merenciano
authors.affiliation: Department of Epidemiology and Evaluation, IMIM-Hospital del Mar, Research Network on Health Services in Chronic Diseases (REDISSEC), Passeig Marítim 25-29, Barcelona, 08003, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Macià
authors.affiliation: Department of Epidemiology and Evaluation, IMIM-Hospital del Mar, Research Network on Health Services in Chronic Diseases (REDISSEC), Passeig Marítim 25-29, Barcelona, 08003, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Castells
authors.affiliation: Department of Epidemiology and Evaluation, IMIM-Hospital del Mar, Research Network on Health Services in Chronic Diseases (REDISSEC), Passeig Marítim 25-29, Barcelona, 08003, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Sala
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010146:Pain / Q000453:epidemiology* / Q000209:etiology*; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D047368:Tumor Burden
keywords: Breast cancer; Comorbidities; Complications; Interval cancer; Persistent pain; Screening