Neuropathic pain prevalence and risk factors in head and neck cancer survivors

Background: Neuropathic pain (NP) is a debilitating symptom among head and neck cancer (HNC) survivors although few large studies report its prevalence and associated risk factors. Methods: A cross-sectional survey assessing demographic, behavioral, and clinical risk factors for NP. NP was assessed using the Self-administered Leeds Assessment of Neuropathic Symptoms and Signs pain scale (S-LANSS). Results: Forty-five percent (227/505) reported having pain including 13.7% (69/505) who were positive for S-LANSS. Reported pain sites were in the regions of the head and oral cavity (46.2%) and neck and throat (41.5%). Despite a higher self-reported use of analgesic medication (NP+ = 41.2%; NP− = 27.4%; p = 0.020) and alternative pain therapies (NP+ = 19.1%; NP− = 8.4%; p = 0.009), severe pain was more prevalent among those with NP (N+ = 23.2%; NP− = 13.3%; p = 0.004). Adjusted for opioid medications, ethnicity/race, age, surgery, depression, and comorbidities were risk factors for NP. Conclusion: NP remains prevalent in HNC survivors highlighting the importance of routine pain surveillance.