尽管儿童癌症幸存者的风险增加，但人们对慢性疼痛的患病率、相关干扰和日常疼痛经历知之甚少。儿童癌症幸存者研究的幸存者（N = 233；平均年龄 = 40.8 岁，范围 22-64 岁；诊断后平均时间 = 32.7 年）完成了疼痛和社会心理测量。患有慢性疼痛的幸存者完成了为期两周的日常测量，使用基于移动健康的生态瞬时评估来评估疼痛和心理症状。多变量修正泊松和线性回归模型分别估计了关键风险因素与慢性疼痛和疼痛干扰的关联的患病率估计值 (PR) 和平均效应 (95% 置信区间 (CI))。多级混合模型检查了日常疼痛的结果以及疼痛对前一天症状的干扰。 96 名幸存者 (41%) 报告有慢性疼痛，其中 23 名 (24%) 患有严重干扰。慢性疼痛与既往静脉甲氨蝶呤治疗（PR = 1.6，95% CI 1.1-2.3）、呼吸系统（PR = 1.8，95% CI 1.2-2.5）、胃肠道（PR = 1.6，95% CI 11.0-2.3）、和神经系统（PR = 1.5，95% CI 1.0-2.1）慢性健康状况、失业（PR = 1.4，95% CI 1.0-1.9）以及临床显着的抑郁和焦虑（PR = 2.9，95% CI 2.0-4.2），以及儿童尤文肉瘤或骨肉瘤的诊断（PR = 1.9，95% CI 1.0-3.5）。较高的疼痛干扰与心血管和神经系统疾病、失业和抑郁和/或焦虑的临床水平以及对癌症复发的恐惧有关。对于男性幸存者来说，睡眠质量低、焦虑加剧和抑郁加剧预示着第二天的疼痛强度和干扰会很高，而女性幸存者则不然。相当一部分儿童癌症幸存者经历慢性疼痛和显着的相关干扰。应定期评估慢性疼痛，并采取干预措施。版权所有 © 2024 作者。由 Wolters Kluwer Health, Inc. 代表国际疼痛研究协会出版。

Although survivors of childhood cancer are at an increased risk, little is known about the prevalence of chronic pain, associated interference, and daily pain experiences. Survivors (N = 233; mean age = 40.8 years, range 22-64 years; mean time since diagnosis = 32.7 years) from the Childhood Cancer Survivor Study completed pain and psychosocial measures. Survivors with chronic pain completed 2-week, daily measures assessing pain and psychological symptoms using mHealth-based ecological momentary assessment. Multivariable-modified Poisson and linear regression models estimated prevalence ratio estimates (PR) and mean effects with 95% confidence intervals (CI) for associations of key risk factors with chronic pain and pain interference, respectively. Multilevel mixed models examined outcomes of daily pain and pain interference with prior day symptoms. Ninety-six survivors (41%) reported chronic pain, of whom 23 (24%) had severe interference. Chronic pain was associated with previous intravenous methotrexate treatment (PR = 1.6, 95% CI 1.1-2.3), respiratory (PR = 1.8, 95% CI 1.2-2.5), gastrointestinal (PR = 1.6, 95% CI 11.0-2.3), and neurological (PR = 1.5, 95% CI 1.0-2.1) chronic health conditions, unemployment (PR = 1.4, 95% CI 1.0-1.9) and clinically significant depression and anxiety (PR = 2.9, 95% CI 2.0-4.2), as well as a diagnosis of childhood Ewing sarcoma or osteosarcoma (PR = 1.9, 95% CI 1.0-3.5). Higher pain interference was associated with cardiovascular and neurological conditions, unemployment and clinical levels of depression and/or anxiety, and fear of cancer recurrence. For male, but not female survivors, low sleep quality, elevated anxiety, and elevated depression predicted high pain intensity and interference the next day. A substantial proportion of childhood cancer survivors experience chronic pain and significant associated interference. Chronic pain should be routinely evaluated, and interventions are needed.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain.