Evidence map›Paper›PMID 40715797›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025

Patient-reported pain severity is associated with shorter survival in older adults with newly diagnosed cancer.

Jennifer Gabbard, Scott Isom, Tiffany Statler, Joanna Asselin, Kathryn E Callahan, Nicholas M Pajewski, Lynne I Wagner, Armida Parala-Metz, Janet A Tooze, Heidi D Klepin

Abstract read
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In one paragraph

Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Opioids and immunosuppression in patients with cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Review
  2. Review
  3. Cancer pain.Nature reviews. Disease primers · 2026
    Review
  4. Review
  5. Comment on "Patient-reported pain severity is associated with shorter survival in older adults with newly diagnosed cancer".Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  6. The potential and limitations of pain as a prognostic indicator in older adults with cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Jennifer GabbardDepartment of Internal Medicine, Section of Gerontology and Geriatrics, School of Medicine, Wake Forest University, 1 Medical Center Boulevard, Winston-Salem, NC, 27157, USA. jennifer.gabbard@advocatehealth.org.ORCID http://orcid.org/0000-0001-8666-4833
Scott IsomDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Tiffany StatlerDepartment of Internal Medicine, Section of Gerontology and Geriatrics, School of Medicine, Wake Forest University, 1 Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
Joanna AsselinDepartment of Internal Medicine, Section of Gerontology and Geriatrics, School of Medicine, Wake Forest University, 1 Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
Kathryn E CallahanDepartment of Internal Medicine, Section of Gerontology and Geriatrics, School of Medicine, Wake Forest University, 1 Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
Nicholas M PajewskiDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Lynne I WagnerDepartment of Social Sciences & Health Policy, School of Medicine, Wake Forest University, Winston-Salem, NC, USA.
Armida Parala-MetzDepartment of Hematology and Oncology, Atrium Health, Charlotte, NC, USA.
Janet A ToozeDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Heidi D KlepinDepartment of Cancer Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

Funding

Tumor Tissue CoreP30CA012197 · NCI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI Ruben A. Mesa · 1985 to 2026
$55.4M
Wake Forest Clinical and Translational Science AwardUL1TR001420 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ARD, JAMY D, FOLEY, KRISTIE L · 2015 to 2023
$32.3M
Implementation Strategies to Promote Advance Care Planning among Persons Living with ADRD and those with Mild Cognitive Impairment in Outpatient Primary Care PracticesK23AG070234 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI Jennifer Lynn Gabbard · 2022 to 2026
$879k
Comprehensive Cancer Center at Wake Forest Baptist Medical Center P30CA012197NCATS NIH HHS UL1 TR001420NCI NIH HHS P30 CA012197NIA NIH HHS K23 AG070234NIA NIH HHS K23AG070234
6 · The paper itself

Abstract

purposePain is a prevalent and often undertreated symptom among older adults with cancer. This study examined whether self-reported pain levels are associated with overall survival (OS) in older adults newly diagnosed with cancer receiving chemotherapy.

methodsThis retrospective cohort study included patients aged ≥ 65 years with newly diagnosed lung, colorectal, or breast cancer between 2017 and 2020, identified via a cancer registry at an academic medical center. Self-reported pain using the numeric rating scale (0-10), documented within 30 days of chemotherapy initiation, was categorized as none (0), mild (1-4), moderate (5-7), or severe (8-10). Baseline demographics, opioid use, and frailty (measured using a deficit accumulation approach) were collected. Kaplan-Meier was used to compare OS between groups. Cox proportional hazards models evaluated the association between pain levels and OS, adjusting for demographics, cancer stage and type, opioid use, and frailty.

resultsAmong 509 patients (median age 72.2 years; 55% female; 83.5% white; 13.4% Black), pain was highly prevalent: 16.5% reported mild, 19.6% moderate, and 17.3% severe pain. Median OS was significantly lower for patients with severe pain (9.1 months, 95% CI 6.5-12.7) compared to those with no pain (29.1 months, p < 0.0001). Severe pain (HR 1.60, 95% CI 1.14-2.24) and moderate pain (HR 1.52, 95% CI 1.10-2.10) were independently associated with higher mortality.

conclusionsSelf-reported pain was significantly associated with reduced OS in older adults with cancer. These findings suggest that self-reported pain may serve as a clinical indicator of poor prognosis and support the role of routine pain assessment in identifying high-risk patients to support patient-centered care.

Indexed as

Cancer PainNeoplasmsAgedAged, 80 and overAnalgesics, OpioidBreast NeoplasmsColorectal NeoplasmsFemaleHumansKaplan-Meier EstimateLung NeoplasmsMalePain MeasurementProportional Hazards ModelsRetrospective StudiesSelf ReportAnalgesics, OpioidCancerFrailtyPainPatient-reported outcome measuresSurvival

Identifiers

PMID40715797
PMCPMC12296996

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.