Prevalence of symptoms in older cancer patients receiving palliative care: a systematic review and meta-analysis

J Pain Symptom Manage. 2014 Jan;47(1):90-104. doi: 10.1016/j.jpainsymman.2013.02.016. Epub 2013 Jun 10.


Context: Symptom control is an essential part of palliative care and important to achieve optimal quality of life. Studies showed that patients with all types of advanced cancer suffer from diverse and often severe symptoms. Research focusing on older persons is scarce because this group is often excluded from studies. Consequently, it is unclear which symptoms older palliative care patients with cancer experience and what is the prevalence of these symptoms. To date, no systematic review has been performed on the prevalence of symptoms in older cancer patients receiving palliative care.

Objectives: The objective of this systematic review was to search and synthesize the prevalence figures of symptoms in older palliative care patients with cancer.

Methods: A systematic search through multiple databases and other sources was conducted from 2002 until April 2012. The methodological quality was evaluated. All steps were performed by two independent reviewers. A meta-analysis was performed to pool the prevalence of symptoms.

Results: Seventeen studies were included in this systematic review. Thirty-two symptoms were identified. The prevalence of these symptoms ranged from 3.5% to 77.8%. The most prevalent symptoms were fatigue, excretory symptoms, urinary incontinence, asthenia, pain, constipation, and anxiety and occurred in at least 50% of patients.

Conclusion: There is a high degree of uncertainty about the reported symptom prevalence because of small sample sizes, high heterogeneity among studies, and the extent of instrument validation. Research based on rigorous methods is needed to allow more conclusive results.

Keywords: Elderly; aged; older person; palliative care; prevalence; signs and symptoms; systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Humans
  • Neoplasms / epidemiology*
  • Neoplasms / physiopathology*
  • Neoplasms / therapy
  • Palliative Care*
  • Prevalence