A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease

J Pain Symptom Manage. 2006 Jan;31(1):58-69. doi: 10.1016/j.jpainsymman.2005.06.007.


Little attention has been paid to the symptom management needs of patients with life-threatening diseases other than cancer. In this study, we aimed to determine to what extent patients with progressive chronic diseases have similar symptom profiles. A systematic search of medical databases (MEDLINE, EMBASE, and PsycINFO) and textbooks identified 64 original studies reporting the prevalence of 11 common symptoms among end-stage patients with cancer, acquired immunodeficiency syndrome (AIDS), heart disease, chronic obstructive pulmonary disease, or renal disease. Analyzing the data in a comparative table (a grid), we found that the prevalence of the 11 symptoms was often widely but homogeneously spread across the five diseases. Three symptoms-pain, breathlessness, and fatigue-were found among more than 50% of patients, for all five diseases. There appears to be a common pathway toward death for malignant and nonmalignant diseases. The designs of symptom prevalence studies need to be improved because of methodological disparities in symptom assessment and designs.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome / epidemiology
  • Acquired Immunodeficiency Syndrome / physiopathology*
  • Acquired Immunodeficiency Syndrome / psychology
  • Aged
  • Aged, 80 and over
  • Depression / psychology
  • Female
  • Heart Diseases / epidemiology
  • Heart Diseases / physiopathology*
  • Heart Diseases / psychology
  • Humans
  • Kidney Diseases / epidemiology
  • Kidney Diseases / physiopathology*
  • Kidney Diseases / psychology
  • Male
  • Middle Aged
  • Neoplasms / etiology
  • Neoplasms / physiopathology*
  • Neoplasms / psychology
  • Palliative Care
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Pulmonary Disease, Chronic Obstructive / psychology