Prevalence and characteristics of persistent pain among head and neck cancer survivors: a systematic review and meta-analysis.

Importance: There are no updated systematic reviews examining the prevalence of persistent pain among head and neck cancer survivors.

Objectives: This systematic review aims to identify the prevalence and characteristics of persistent pain across locations among head and neck cancer survivors.

Design: A systematic review and meta-analysis.

Participants: Head and neck cancer survivors with persistent pain.

Methods: It was conducted according to PRISMA guidelines on December 14th, 2023 (PROSPERO reference CRD42024494926). The MEDLINE via PubMed, Scopus, Web of Science, CINAHL, Ovid and Cochrane Library databases were searched. Studies had to report prevalence data on persistent pain in head and neck cancer survivors who completed cancer treatment at least 3 months ago. Quality of the included studies was assessed using the critical appraisal tool developed by the Joanna Briggs Institute. Statistical heterogeneity was assessed prior to perform the meta-analysis using τ2, I2, and Q. Univariate meta-regression analyses were used to examine sources of heterogeneity.

Results: 1713 records were retrieved. After removing duplicates 1385 articles were screened. Ultimately, 182 articles were assessed for full-text screening, of which 17 manuscripts were included for review. The prevalence of the studies was 31% (95% CI, 20 to 42). The meta-regression explained approximately 40% of the observed heterogeneity (R2 = 40.57).

Conclusions: This systematic review highlights that almost third of head and neck cancer survivors are under persistent pain after finishing cancer treatment. No final conclusions can be drawn as to which extent cancer location, cancer treatment, pain measurement method and timing of pain assessments could modify this prevalence. Results should be interpreted with caution since there is considerable variability in the methods.