Identification of high-impact chronic pain among cancer survivors: a cross-sectional study using the Graded Chronic Pain Scale framework

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PURPOSE: Chronic cancer-related pain is a prevalent and often under-recognized issue among individuals living with or after cancer. Clinically useful tools are needed to classify pain severity and impact and to identify those requiring targeted support. This study applied the Graded Chronic Pain Scale-Revised (GCPS-R) in a cohort of cancer survivors and examined differences in pain characteristics and psychosocial factors across GCPS-R subgroups. Secondly, the study compared pain characteristics in cancer survivors with high-impact chronic pain (HICP) to an age- and sex-matched sample of patients with non-cancer HICP. METHODS: Patients attending a residential cancer rehabilitation course completed a screening questionnaire and a pain-specific module including the GCPS-R and validated measures of disability, psychological distress, pain catastrophizing, and self-rated health. Cancer survivors with HICP were matched 1:3 to patients with non-cancer HICP using registry data collected prior to their initial consultation at an interdisciplinary Pain Center. RESULTS: Among 270 cancer survivors included in the analysis, 61% were classified as having HICP. Increasing GCPS-R impact levels were associated with greater pain intensity and disability, higher psychological distress and pain catastrophizing, and poorer self-rated health and quality of life (p < 0.05). Compared with matched non-cancer patients with HICP, cancer survivors reported lower pain intensity and catastrophizing but were at least as likely to meet criteria for widespread pain. CONCLUSION: HICP is present among cancer survivors seeking rehabilitation. The GCPS-R can differentiate clinically meaningful subgroups and may support systematic assessment of pain severity and impact to identify patients requiring targeted support.

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