936P - Chronic pain in cancer survivors: Head and neck versus other cancers

Background

There are over 500,000 survivors of head and neck cancer (HNC) in the United States. While chronic pain is a common symptom across all cancer sites, we hypothesized it is more prevalent in HNC compared with other cancer sites, due to tumor location, treatment modality and functional impairment associated with HNC.

Methods

To compare self-reported chronic pain prevalence, we built a retrospective cohort of adult survivors with a history of cancer, using the National Health Interview Survey (NHIS) from 2010 to 2021. Study participants were grouped into HNC (n = 354) vs. other cancer survivors (n = 24,055), based on self-report of a previous cancer diagnosis. We estimated weighted prevalence rates of chronic pain in our sample, and in the final models, we estimated odds of reporting chronic pain while adjusting for sociodemographic (race, insurance, education, income, employment and smoking history) and clinical (depression, and self-rated health status) factors, using multivariate logistic regression analysis.

Results

Weighted, age-adjusted prevalence of chronic pain was significantly higher in HNC compared to other cancers (HNC = 45.5%, 95% CI: 42.6%, 48.5% vs. other cancers = 31.6%, 95% CI: 29.9%, 33.2%; p = 0.02). After adjusting for clinical and sociodemographic covariates, odds of reporting chronic pain remained significantly higher among HNC survivors compared to other cancers (aOR=1.34, 95% CI: 1.03, 1.75). Other factors associated with self-reported chronic pain included having depression (aOR=2.03, 95% CI: 1.90, 2.17), ≥ 65 years (aOR=0.74, 95% CI: 0.68, 0.80), being Hispanic (aOR=0.70, 95% CI:0.59, 0.83) compared to a non-Hispanic White, having private insurance (aOR=0.74, 95% CI: 0.69, 0.80), and education below high school level (aOR=1.39, 95% CI: 1.24, 1.56).

Conclusions

Chronic pain is highly prevalent among survivors of HNC, with almost 50% reporting chronic pain. Additionally, survivors of HNC are 34 percent more likely to report chronic pain compared to non-HNC survivors. Our findings highlight the burden of chronic pain in cancer, and the pressing need for effective pain management especially in HNC survivors.

Clinical trial identification

Editorial acknowledgement

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.