This study aims to first investigate whether central sensitization is present in colorectal cancer patients with pain symptoms, and second, to explore the factors associated with central sensitization in this patient population.
This observational study was part of a prospective clinical trial (ChiCTR2400086387) and received ethics approval from the Institutional Review Board of the Sixth Affiliated Hospital of Sun Yat-sen University. Participants were recruited from patients admitted to the Department of Gastrointestinal Surgery at the Sixth Affiliated Hospital. Eligible participants had a confirmed diagnosis of colorectal cancer (stage I-IV) and reported experiencing pain. Patients with chronic pain unrelated to cancer or those with other cancers were excluded. Pain intensity was assessed using the Brief Pain Inventory (BPI), while the presence of central sensitization was evaluated using the validated Chinese version of the Central Sensitization Inventory (CSI). Health-related quality of life was measured through the EQ-5D and the Functional Assessment of Cancer Therapy-Colorectal (FACT-C). Central sensitization was determined based on CSI scores, and multivariate logistic regression was performed to identify potential predictors of central sensitization in colorectal cancer patients.
A total of 106 colorectal cancer patients awaiting surgery were enrolled in the study. Over 30% reported moderate-to-severe cancer-related pain, with pain intensity exceeding 6 out of 10 in the past 24 hours, and more than 20% required analgesics for pain management. The average pain intensity was 5.23 out of 10. Notably, over a quarter of the patients exhibited signs of central sensitization. Binary logistic regression analysis indicated that lower quality of life scores and a history of radiotherapy were significantly associated with the presence of central sensitization.
Moderate-to-severe pain was common among colorectal cancer patients prior to surgery. More importantly, central sensitization was observed in those with pain and was significantly associated with a reduced quality of life and a history of radiotherapy.
Our study demonstrated that central sensitization influences pain manifestations in colorectal cancer patients, underscoring the need for further research to explore the underlying mechanisms of centrally mediated cancer pain. A deeper understanding of these mechanisms in future studies may lead to more effective pain management strategies.
colorectal cancer
cancer pain
