MANCHESTER, England--Even one day of pain can signal an excess rate of cancer mortality over the next eight years, according to British epidemiologists.

In a prospective study of 6,569 persons who participated a decade ago in two pain studies, cancer accounted for nearly all the excess mortality of the 1,005 respondents (15%) who'd said in a mail questionnaire they'd had widespread pain in the previous month lasting at least one day, and of the 3,176 (48%) who'd had regional pain. There were 2,388 who said they had no pain.

The mortality rate was 20% higher for those who had regional pain, but the cancer mortality for those with regional pain was three times as high, Dr. Gary J. Macfarlane of the University of Manchester and colleagues reported in the Sept. 22 British Medical Journal. The assessment was made after excluding the 226 people in the sample who'd already been diagnosed with cancer.

For those without a cancer diagnosis who reported widespread pain in the previous month, the rate of cancer mortality over the next eight years was more than twice as high as it was for those with no pain.

Lung, colon, and breast were the three most common malignancies among the 654 people who died.

In an accompanying editorial, epidemiologist Iain Crombie of the University of Dundee in Scotland said the finding could be the result of an unrecognized bias, a statistical fluke, or "the possibility that pain is an early symptom of undiagnosed cancer."

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