Prevalence of self-reported pain in patients 5 years after rectal cancer treatment: results from the prospective QoLiRECT cohort study

BACKGROUND AND PURPOSE: Pain as a long-term outcome following rectal cancer treatment has received limited attention in previous studies. This prospective cohort study examined pain prevalence up to 5 years post-surgery in patients treated with curative intent. Secondary aims included evaluating pain intensity and its interference with daily life, and comparing pain experiences with a reference population. In addition, potential risk factors for pain were explored. Patient/material and methods: The study is based on the multicenter prospective cohort study QoLiRECT including patients from 16 surgical departments in Denmark and Sweden (2012-2015). Questionnaires regarding Quality of Life were administered at diagnosis and at 1, 2 and 5 years after treatment. Information about self-assessed pain was primarily derived from the 'Brief Pain Inventory - Short Form'. Comparisons were made with an age- and sex- matched reference population. RESULTS: Five years post-treatment, 37% of rectal cancer survivors reported pain exceeding common types of pain, with an average pain level of 3.8 and interference score of 3.1 (range 0-10). Pain was mainly located to the lower extremities, back and pelvis. Surprisingly, pain prevalence was higher in the reference population (53%), a difference consistent at all time points. No significant difference was found between groups regarding average pain or interference. Higher pain levels were associated with female sex, severe baseline pain, and elevated Body Mass Index (BMI). INTERPRETATION: Pain was more common in the reference population, while intensity and interference were similar between groups. This suggests that the experience of pain may differ after surviving cancer, and such differences might be considered when studying pain in cancer survivors.