Are there differences in the prevalence of palliative care-related problems in people living with advanced cancer and eight non-cancer conditions? A systematic review

J Pain Symptom Manage. 2014 Oct;48(4):660-77. doi: 10.1016/j.jpainsymman.2013.11.009. Epub 2014 May 5.


Context: If access to effective palliative care is to extend beyond cancer patients, an understanding of the comparative prevalence of palliative care problems among cancer and non-cancer patients is necessary.

Objectives: This systematic review aimed to describe and compare the prevalence of seventeen palliative care-related problems across the four palliative care domains among adults with advanced cancer, acquired immune deficiency syndrome, chronic heart failure, end-stage renal disease (ESRD), chronic obstructive pulmonary disease, multiple sclerosis, motor neuron disease, Parkinson's disease, and dementia.

Methods: Three databases were searched using three groups of keywords. The results of the extraction of the prevalence figures were summarized.

Results: The electronic searches yielded 4697 hits after the removal of 1784 duplicates. Of these hits, 143 met the review criteria. The greatest number of studies were found for advanced cancer (n=57) and ESRD patients (n=47), and 75 of the 143 studies used validated scales. Few data were available for people living with multiple sclerosis (n=2) and motor neuron disease (n=3). The problems with a prevalence of 50% or more found across most of the nine studied diagnostic groups were: pain, fatigue, anorexia, dyspnea, and worry.

Conclusion: There are commonalities in the prevalence of problems across cancer and non-cancer patients, highlighting the need for palliative care to be provided irrespective of diagnosis. The methodological heterogeneity across the studies and the lack of non-cancer studies need to be addressed in future research.

Keywords: Prevalence; acquired immune deficiency syndrome; cancer; chronic obstructive pulmonary disease; dementia; heart diseases; neurodegenerative diseases; palliative care; renal disease.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Causality
  • Chronic Disease / therapy*
  • Comorbidity
  • Gastrointestinal Diseases / epidemiology*
  • Humans
  • Incidence
  • Mental Disorders / epidemiology*
  • Neoplasms / epidemiology*
  • Neoplasms / therapy*
  • Pain / epidemiology*
  • Palliative Care / statistics & numerical data*
  • Prevalence
  • Risk Assessment