Systematic Review of Guidelines for the Management of Patients with Cancer Pain

Background To improve the quality of pain management in cancer patients, clinical guidelines have been published and revised around the world. Whereas, there are large gaps in evidence-based resources across cancer pain management guidelines, and there is an urgent need for high-quality systematic evaluation of guidelines to bridge the practice gap. Objective To systematically review the relevant guidelines for treating cancer pain patients, analyze the similarities and differences between the recommendations of each guide, and provide an evidence-based decision reference for clinical practice. Methods A systematic search of PubMed, Web of Science, Cochrane Library, CNKI, Wanfang Data, CBM, BP, SIGN, NGC, Medical Communication, and the websites of relevant societies and industry bodies for guidelines on the management of patients with cancer pain was performed. The search timeframe was from the construction of the database to October 9, 2023. The literature was screened by two investigators according to the inclusion and exclusion criteria, and the guidelines were evaluated for quality using the Appraisal of Guidelines for Research & EvaluationⅡ (AGREE Ⅱ) to summarise the recommendations of each guideline related to managing pain in cancer patients. Results Seven guidelines were ultimately included, developed for the period 2016-2023, including two from the United States, two from Switzerland, one from Canada, one from Latin America, and one from Japan, all with guideline recommendation level A. The related recommendations were mainly focused on 4 aspects: cancer pain assessment, pharmacological management, non-pharmacological management, and cancer pain education. Conclusion The recommendations of the 7 guidelines can provide a new reference for the practice of cancer pain management in China. It is suggested that clinical practitioners should consider the specific conditions of patients and work with multidisciplinary cooperation to truly achieve the "5A" goal of cancer pain management.