Clinical and Translational Oncology

, Volume 21, Issue 3, pp 380–390 | Cite as

Active study: undetected prevalence and clinical inertia in the treatment of breakthrough cancer pain (BTcP)

  • C. Camps HerreroEmail author
  • J. J. Reina Zoilo
  • D. Monge Martín
  • F. Caballero Martínez
  • V. Guillem Porta
  • E. Aranda Aguilar
  • A. Carrato Mena
  • E. Díaz-Rubio García
  • J. García-Foncillas López
  • M. Feijóo Saus
  • R. López López
Brief Research Article



To prove if there is clinical inertia in the identification and treatment of episodes of breakthrough cancer pain (BTcP), comparing actual results from clinical practice with clinical oncologists’ prior perception.


Observational and descriptive study, using information collected by practising medical oncologists, at three moments: (a) questionnaire regarding their professional judgement of the handling of patients with BTcP in their practice, (b) cross-sectional clinical screening, to detect possible existing cases of BTcP in a representative sample of their patients, (c) retrospective self-audit of clinical case histories of patients diagnosed with BTcP to find out about how it has been handled.

Participants and study period

A random sample on a state level of 108 specialists in medical oncology. 540 patients who suffer some type of cancer pain on the designated study date for each specialist (July–December 2016).


The global prevalence of BTcP in the study sample covered 91.3% of the patients who were suffering some type of cancer pain. Barely 2% of the doctors surveyed suspected figures around this mark. 40.9% of the cases had not been previously detected as BTcP by their doctors. Although 90% of the patients who had previously been diagnosed with BTcP received a specific analgesic treatment for the symptoms, 42% of those patients with known BTcP were not able to control their episodes of pain.


Clinical inertia is a serious problem in the handling of BTcP in medical oncology services, where it is the subject of a significantly low level of detection and treatment, despite the contrasting perception of specialists.


Breakthrough cancer pain (BTcP) Clinical inertia Prevalence of BTcP 



The Active study is a scientific initiative by the Foundation to further the Excellence and Quality of Oncology (ECO in Spanish) and the Francisco de Vitoria University in Madrid. The authors thank all of the medical oncologists who took part in the survey for their contribution to the study.


This study was funded by Kyowa Kirin Farmacéutica S.L.U., through the ECO Foundation.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was realized in agreement by the ethical requirements of the declaration of Helsinki, review of Scotland (October, 2000) for the investigation by human beings.

Informed consent

All persons gave their informed consent prior to their inclusion in the study.


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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2018

Authors and Affiliations

  • C. Camps Herrero
    • 1
    Email author
  • J. J. Reina Zoilo
    • 2
  • D. Monge Martín
    • 3
  • F. Caballero Martínez
    • 3
  • V. Guillem Porta
    • 4
  • E. Aranda Aguilar
    • 5
  • A. Carrato Mena
    • 6
  • E. Díaz-Rubio García
    • 7
  • J. García-Foncillas López
    • 8
  • M. Feijóo Saus
    • 9
  • R. López López
    • 10
  1. 1.Medical Oncology ServiceGeneral University Hospital of Valencia, CIBERONCValenciaSpain
  2. 2.Medical Oncology ServiceUniversity Hospital Virgen MacarenaSevilleSpain
  3. 3.Degree in Medicine, Department of Health SciencesFrancisco de Vitoria UniversityMadridSpain
  4. 4.Oncology ServiceValencian Institute of Oncology FoundationValenciaSpain
  5. 5.Oncology ServiceUniversity Hospital Reina SofíaCórdobaSpain
  6. 6.Medical Oncology ServiceUniversity Hospital Ramon y Cajal, IRYCIS, CIBERONCMadridSpain
  7. 7.Oncology ServiceClinical Hospital San CarlosMadridSpain
  8. 8.Oncology Service of the Jiménez Díaz FoundationMadridSpain
  9. 9.Medical Oncology ServiceUniversity Hospital La MoralejaMadridSpain
  10. 10.Medical Oncology ServiceUniversity Hospital Complex of Santiago de CompostelaSantiago de CompostelaSpain

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