COSMIN database

Classification of pain in cancer patients--a systematic literature review

Knudsen, A. K., Aass, N., Fainsinger, R., Caraceni, A., Klepstad, P., Jordhoy, M., Hjermstad, M. J., and Kaasa, S.
One of the aims of the European Palliative Care Research Collaborative (EPCRC) is to achieve consensus on a classification system for cancer pain. We performed a systematic literature review to identify existing classification systems and domains/items used to classify cancer patients with pain. In a systematic search in the databases Medline and Embase, covering 1986-2006, 692 hits were obtained. 92 papers were evaluated to address pain classification. Six standardised classification systems were identified; three of them systematically developed and partially validated. Both pain characteristics and patient characteristics relevant for cancer pain classification were included in the classification systems. All but one of the standardised systems aim at predicting treatment response or adequacy of treatment. Several domains and items used to describe cancer pain but not formally described as part of a classification system were also identified and systematized. The existing approaches to pain classification in cancer patients are different, mostly not thoroughly validated, and none is widely applied. An internationally accepted classification system for cancer pain could improve research and cancer pain management. This systematic review suggests a need for developing an international consensus on how to classify pain in cancer patients.
Palliat Med
1477-030X (Electronic)
Publication year:
Symptom status:
Cognitive/mental state
Emotional state
Physical state
Functional status:
Cognitive/mental functioning
Adults (18-65)
Children (0-18)
Seniors (65+)
Neoplasms and related symptoms
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
2 - Interviews
6 - Clinical rating scales
CPPS - Cancer Pain Prognostic Scale
ECS-CP - Edmonton Classification System for Cancer Pain
IASP Classification of Chronic Pain - International Association for the Study of Pain Classification of Chronic Pain
OEI - Opioid Escalation Index
PMI - Pain Management Index
Prognostic tool for pain treatment