Association of widespread body pain with an increased risk of cancer and reduced cancer survival

J. McBeth, A. J. Silman, Gary John MacFarlane

Research output: Contribution to journalEditorial

79 Citations (Scopus)

Abstract

Objective. To determine whether reported widespread body pain is related to an increased incidence of cancer and/or reduced survival from cancer, since our previous population surveys have demonstrated a relationship between widespread body pain and a subsequent 2-fold increase in mortality from cancer over an 8-year period.

Methods. A total of 6,565 subjects in Northwest England participated in 2 health surveys during 1991-1992. The subjects were classified according to their reported pain status (no pain, regional pain, and widespread pain), and were subsequently followed up prospectively until December 31, 1999. During followup, information was collected on incidence of cancer and survival rates among those developing cancer. Associations between the original pain status, and development of cancer and cancer survival were expressed as the incidence rate ratio (IRR) and mortality rate ratio (MRR), respectively. All analyses were adjusted for age, sex, and study location, the latter being a proxy measure of socioeconomic status.

Results. Among the study population, 6,331 had never been diagnosed with cancer at the time of participation in the survey. Of these subjects, 956 (15%) were classified as having widespread pain, 3,061 (48%) as having regional pain, and 2,314 (37%) as having no pain. There were a total of 395 first malignancies recorded during followup. In comparison with subjects reporting no pain, those with regional pain (IRR 1.19, 95% confidence interval [95% CI] 0.94-1.50) and widespread pain (IRR 1.61, 95% CI 1.21-2.13) experienced an excess incidence of cancer during the followup period. The increased incidence among subjects previously reporting widespread pain was related, most strongly, to breast cancer (IRR 3.67, 95% CI 1.39-9.68), but there were also cancers of the prostate (IRR 3.46, 95% CI 1.25-9.59), large bowel (IRR 2.35, 95% CI 0.96-5.77), and lung (IRR 2.04, 95% CI 0.96-4.34). Subjects reporting widespread pain who subsequently developed cancer, in comparison with those previously reporting no pain, had an increased risk of death (MRR 1.82, 95% CI 1.18-2.80). This decreased survival was highest among subjects with cancers of the breast and prostate, although the effects on site-specific survival were nonsignificant.

Conclusion. This study has demonstrated that widespread pain reported in population surveys is associated with a substantial subsequent increased incidence of cancer and reduced cancer survival. At present there are no satisfactory biologic explanations for this observation, although several possible leads have been identified.

Original languageEnglish
Pages (from-to)1686-1692
Number of pages6
JournalArthritis & Rheumatism
Volume48
DOIs
Publication statusPublished - 2003

Keywords

  • GROWTH-FACTOR-I
  • GENERAL-POPULATION
  • PROSTATE-CANCER
  • BREAST-CANCER
  • FIBROMYALGIA SYNDROME
  • FOLLOW-UP
  • PREVALENCE
  • DEPRESSION
  • DISABILITY
  • MORTALITY

Cite this

Association of widespread body pain with an increased risk of cancer and reduced cancer survival. / McBeth, J.; Silman, A. J.; MacFarlane, Gary John.

In: Arthritis & Rheumatism, Vol. 48, 2003, p. 1686-1692.

Research output: Contribution to journalEditorial

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title = "Association of widespread body pain with an increased risk of cancer and reduced cancer survival",
abstract = "Objective. To determine whether reported widespread body pain is related to an increased incidence of cancer and/or reduced survival from cancer, since our previous population surveys have demonstrated a relationship between widespread body pain and a subsequent 2-fold increase in mortality from cancer over an 8-year period.Methods. A total of 6,565 subjects in Northwest England participated in 2 health surveys during 1991-1992. The subjects were classified according to their reported pain status (no pain, regional pain, and widespread pain), and were subsequently followed up prospectively until December 31, 1999. During followup, information was collected on incidence of cancer and survival rates among those developing cancer. Associations between the original pain status, and development of cancer and cancer survival were expressed as the incidence rate ratio (IRR) and mortality rate ratio (MRR), respectively. All analyses were adjusted for age, sex, and study location, the latter being a proxy measure of socioeconomic status.Results. Among the study population, 6,331 had never been diagnosed with cancer at the time of participation in the survey. Of these subjects, 956 (15{\%}) were classified as having widespread pain, 3,061 (48{\%}) as having regional pain, and 2,314 (37{\%}) as having no pain. There were a total of 395 first malignancies recorded during followup. In comparison with subjects reporting no pain, those with regional pain (IRR 1.19, 95{\%} confidence interval [95{\%} CI] 0.94-1.50) and widespread pain (IRR 1.61, 95{\%} CI 1.21-2.13) experienced an excess incidence of cancer during the followup period. The increased incidence among subjects previously reporting widespread pain was related, most strongly, to breast cancer (IRR 3.67, 95{\%} CI 1.39-9.68), but there were also cancers of the prostate (IRR 3.46, 95{\%} CI 1.25-9.59), large bowel (IRR 2.35, 95{\%} CI 0.96-5.77), and lung (IRR 2.04, 95{\%} CI 0.96-4.34). Subjects reporting widespread pain who subsequently developed cancer, in comparison with those previously reporting no pain, had an increased risk of death (MRR 1.82, 95{\%} CI 1.18-2.80). This decreased survival was highest among subjects with cancers of the breast and prostate, although the effects on site-specific survival were nonsignificant.Conclusion. This study has demonstrated that widespread pain reported in population surveys is associated with a substantial subsequent increased incidence of cancer and reduced cancer survival. At present there are no satisfactory biologic explanations for this observation, although several possible leads have been identified.",
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TY - JOUR

T1 - Association of widespread body pain with an increased risk of cancer and reduced cancer survival

AU - McBeth, J.

AU - Silman, A. J.

AU - MacFarlane, Gary John

PY - 2003

Y1 - 2003

N2 - Objective. To determine whether reported widespread body pain is related to an increased incidence of cancer and/or reduced survival from cancer, since our previous population surveys have demonstrated a relationship between widespread body pain and a subsequent 2-fold increase in mortality from cancer over an 8-year period.Methods. A total of 6,565 subjects in Northwest England participated in 2 health surveys during 1991-1992. The subjects were classified according to their reported pain status (no pain, regional pain, and widespread pain), and were subsequently followed up prospectively until December 31, 1999. During followup, information was collected on incidence of cancer and survival rates among those developing cancer. Associations between the original pain status, and development of cancer and cancer survival were expressed as the incidence rate ratio (IRR) and mortality rate ratio (MRR), respectively. All analyses were adjusted for age, sex, and study location, the latter being a proxy measure of socioeconomic status.Results. Among the study population, 6,331 had never been diagnosed with cancer at the time of participation in the survey. Of these subjects, 956 (15%) were classified as having widespread pain, 3,061 (48%) as having regional pain, and 2,314 (37%) as having no pain. There were a total of 395 first malignancies recorded during followup. In comparison with subjects reporting no pain, those with regional pain (IRR 1.19, 95% confidence interval [95% CI] 0.94-1.50) and widespread pain (IRR 1.61, 95% CI 1.21-2.13) experienced an excess incidence of cancer during the followup period. The increased incidence among subjects previously reporting widespread pain was related, most strongly, to breast cancer (IRR 3.67, 95% CI 1.39-9.68), but there were also cancers of the prostate (IRR 3.46, 95% CI 1.25-9.59), large bowel (IRR 2.35, 95% CI 0.96-5.77), and lung (IRR 2.04, 95% CI 0.96-4.34). Subjects reporting widespread pain who subsequently developed cancer, in comparison with those previously reporting no pain, had an increased risk of death (MRR 1.82, 95% CI 1.18-2.80). This decreased survival was highest among subjects with cancers of the breast and prostate, although the effects on site-specific survival were nonsignificant.Conclusion. This study has demonstrated that widespread pain reported in population surveys is associated with a substantial subsequent increased incidence of cancer and reduced cancer survival. At present there are no satisfactory biologic explanations for this observation, although several possible leads have been identified.

AB - Objective. To determine whether reported widespread body pain is related to an increased incidence of cancer and/or reduced survival from cancer, since our previous population surveys have demonstrated a relationship between widespread body pain and a subsequent 2-fold increase in mortality from cancer over an 8-year period.Methods. A total of 6,565 subjects in Northwest England participated in 2 health surveys during 1991-1992. The subjects were classified according to their reported pain status (no pain, regional pain, and widespread pain), and were subsequently followed up prospectively until December 31, 1999. During followup, information was collected on incidence of cancer and survival rates among those developing cancer. Associations between the original pain status, and development of cancer and cancer survival were expressed as the incidence rate ratio (IRR) and mortality rate ratio (MRR), respectively. All analyses were adjusted for age, sex, and study location, the latter being a proxy measure of socioeconomic status.Results. Among the study population, 6,331 had never been diagnosed with cancer at the time of participation in the survey. Of these subjects, 956 (15%) were classified as having widespread pain, 3,061 (48%) as having regional pain, and 2,314 (37%) as having no pain. There were a total of 395 first malignancies recorded during followup. In comparison with subjects reporting no pain, those with regional pain (IRR 1.19, 95% confidence interval [95% CI] 0.94-1.50) and widespread pain (IRR 1.61, 95% CI 1.21-2.13) experienced an excess incidence of cancer during the followup period. The increased incidence among subjects previously reporting widespread pain was related, most strongly, to breast cancer (IRR 3.67, 95% CI 1.39-9.68), but there were also cancers of the prostate (IRR 3.46, 95% CI 1.25-9.59), large bowel (IRR 2.35, 95% CI 0.96-5.77), and lung (IRR 2.04, 95% CI 0.96-4.34). Subjects reporting widespread pain who subsequently developed cancer, in comparison with those previously reporting no pain, had an increased risk of death (MRR 1.82, 95% CI 1.18-2.80). This decreased survival was highest among subjects with cancers of the breast and prostate, although the effects on site-specific survival were nonsignificant.Conclusion. This study has demonstrated that widespread pain reported in population surveys is associated with a substantial subsequent increased incidence of cancer and reduced cancer survival. At present there are no satisfactory biologic explanations for this observation, although several possible leads have been identified.

KW - GROWTH-FACTOR-I

KW - GENERAL-POPULATION

KW - PROSTATE-CANCER

KW - BREAST-CANCER

KW - FIBROMYALGIA SYNDROME

KW - FOLLOW-UP

KW - PREVALENCE

KW - DEPRESSION

KW - DISABILITY

KW - MORTALITY

U2 - 10.1002/art.10973

DO - 10.1002/art.10973

M3 - Editorial

VL - 48

SP - 1686

EP - 1692

JO - Arthritis & Rheumatism

JF - Arthritis & Rheumatism

SN - 0004-3591

ER -