Prevalência e incidência de dor neuropática relacionada ao câncer em uma população de alta vulnerabilidade social

Abstract

Introduction: Cancer-related neuropathic pain (CNNP) is complex to manage and has a negative impact on people's quality of life. Epidemiological data, which are exceptional, suggest that the average prevalence of this type of pain is around 40%. Thus, the objective of this study was to identify the prevalence and incidence of DNRC and to evaluate its impact on the mood and sleep of cancer patients in a region of high social vulnerability, which has the worst HDI (Human Development Index) in Brazil (0.676). Method: a cross-sectional study was carried out in the period 2019 - 2021, in the two public reference hospitals in cancer in the state of Maranhão, both located in the state capital. The following procedures were used: Douleur Neuropathique 4 - DN4, Hospital Anxiety and Depression Scale – HADS, Mini-Sleep and Karnofsky Performance Status – KPS, in addition to a socioeconomic and clinical experiment to characterize the population. Results: One thousand and twenty (1020) patients participated in the study, mostly women (61%), African descendants (79%), with low education (85%), monthly income of up to 1 minimum wage (65%), from from rural areas (71%) and diagnosed with breast cancer (20%) and cervical cancer (17%). The prevalence of DNRC was 62.5%, while the incidence was 21.4%. The pain was daily in 90% of the people and of moderate intensity in 53% of them. Anxiety was identified in 56% of individuals with DNRC, depression in 51% and sleep disturbance in 41%. The variables female gender, breast and cervical cancer, presence of metastasis, anxiety, depression, moderate change in sleep pattern, pain irradiation and radiotherapy, were presented as a risk factor for DNCR (p < 0.05; CI 95%). Conclusion: The prevalence of DNRC was 62.5% and the incidence, 21.4%. Most patients with DNRC were women, of African descent, with low education, low income, from rural areas, diagnosed with breast cancer and cervical cancer, with the presence of anxiety, depression and sleep disturbance, impacting directly in the daily life of this population, which is diagnosed at an advanced stage of the disease due to difficult access to health services and therapeutic limitations, in addition to the shortage of professionals and specialized services throughout the state.