{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:36:55Z","timestamp":1760146615221,"version":"build-2065373602"},"reference-count":44,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: There is a scarcity of data on the long-term relationship between cancer and chronic low back pain (CLBP). Therefore, this retrospective cohort study investigated the association between cancer and the 10-year incidence of CLBP in Germany. Methods: Data collected in 1293 German general practices between 2005 and 2022 were used for the study. Patients diagnosed with cancer were matched to those without cancer (1:1) using a propensity score based on age, sex, the mean number of consultations per year during the follow-up, index year, and several chronic conditions. The index date was the consultation corresponding to cancer diagnosis in the cancer group and a random visit date in the noncancer group. The analyses included Kaplan\u2013Meier curves with the log-rank test and Cox regression models adjusted for other frequent conditions. Results: There were 203,657 adults in the cancer group and 203,657 adults in the noncancer group. The mean (SD) age was 66.2 (14.6) and 66.0 (13.8) years in patients with and without cancer, respectively, with a proportion of women of 51.3\u201351.8%. Within 10 years of the index date, 16.1% of people with cancer and 18.8% of those without cancer were diagnosed with CLBP (p-value &lt; 0.001). The Cox regression analysis corroborated this finding, as there was a negative and significant association between cancer and CLBP (HR = 0.87, 95% CI = 0.86\u20130.89). Conclusions: Cancer was not associated with increased odds of CLBP in the decade following its diagnosis in Germany. Due to limitations inherent to the data, caution should be taken when interpreting the study results.<\/jats:p>","DOI":"10.3390\/jcm13226969","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T10:44:37Z","timestamp":1732013077000},"page":"6969","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cancer and the 10-Year Incidence of Chronic Low Back Pain in 407,314 Adults Followed in General Practices in Germany"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2124-7227","authenticated-orcid":false,"given":"Karel","family":"Kostev","sequence":"first","affiliation":[{"name":"Epidemiology, IQVIA, 60549 Frankfurt, Germany"},{"name":"University Clinic, Phillips-University, 35043 Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1087-7768","authenticated-orcid":false,"given":"Augustin","family":"Latourte","sequence":"additional","affiliation":[{"name":"AP-HP, Universit\u00e9 Paris Cit\u00e9, Lariboisi\u00e8re Hospital, Department of Rheumatology, 75010 Paris, France"},{"name":"Universit\u00e9 Paris Cit\u00e9, Inserm U1132, Bioscar, 75010 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1628-9948","authenticated-orcid":false,"given":"Dong Keon","family":"Yon","sequence":"additional","affiliation":[{"name":"Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul 130-701, Republic of Korea"},{"name":"Department of Regulatory Science, Kyung Hee University, Seoul 130-701, Republic of Korea"},{"name":"Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul 130-701, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep Maria","family":"Haro","sequence":"additional","affiliation":[{"name":"Research and Development Unit, Parc Sanitari Sant Joan de D\u00e9u, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2132-4074","authenticated-orcid":false,"given":"Pascal","family":"Richette","sequence":"additional","affiliation":[{"name":"AP-HP, Universit\u00e9 Paris Cit\u00e9, Lariboisi\u00e8re Hospital, Department of Rheumatology, 75010 Paris, France"},{"name":"Universit\u00e9 Paris Cit\u00e9, Inserm U1132, Bioscar, 75010 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johann","family":"Beaudreuil","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Inserm U1132, Bioscar, 75010 Paris, France"},{"name":"AP-HP, Universit\u00e9 Paris Cit\u00e9, Lariboisi\u00e8re-Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation, 75010 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1071-1239","authenticated-orcid":false,"given":"Louis","family":"Jacob","sequence":"additional","affiliation":[{"name":"Research and Development Unit, Parc Sanitari Sant Joan de D\u00e9u, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain"},{"name":"AP-HP, Universit\u00e9 Paris Cit\u00e9, Lariboisi\u00e8re-Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation, 75010 Paris, France"},{"name":"Universit\u00e9 Paris Cit\u00e9, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), 75010 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2147\/JPR.S171729","article-title":"Chronic Low Back Pain and Postural Rehabilitation Exercise: A Literature Review","volume":"12","author":"Paolucci","year":"2019","journal-title":"J. Pain Res."},{"key":"ref_2","unstructured":"(2023). GBD 2021 Low Back Pain Collaborators Global, Regional, and National Burden of Low Back Pain, 1990-2020, Its Attributable Risk Factors, and Projections to 2050: A Systematic Analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol., 5, e316\u2013e329."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/ner.12018","article-title":"Epidemiology of Low Back Pain in Adults","volume":"17","author":"Manchikanti","year":"2014","journal-title":"Neuromodulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e000569","DOI":"10.1136\/bmjdrc-2018-000569","article-title":"Is Chronic Low Back Pain a Risk Factor for Diabetes? The Nord-Tr\u00f8ndelag Health Study","volume":"6","author":"Heuch","year":"2018","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"105725","DOI":"10.1016\/j.clineuro.2020.105725","article-title":"Increased Risk of Strokes in Patients with Chronic Low Back Pain (CLBP): A Nationwide Population-Based Cohort Study","volume":"192","author":"Wang","year":"2020","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1186\/s12955-018-1018-4","article-title":"Chronic Back Pain and Its Association with Quality of Life in a Large French Population Survey","volume":"16","author":"Husky","year":"2018","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1007\/s11606-018-4680-7","article-title":"Study of Osteoporotic Fractures Association of Back Pain with All-Cause and Cause-Specific Mortality Among Older Women: A Cohort Study","volume":"34","author":"Roseen","year":"2019","journal-title":"J. Gen. Intern. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1080\/14034940210133951","article-title":"Low Back Pain as a Predictor of Long-Term Work Disability","volume":"30","author":"Natvig","year":"2002","journal-title":"Scand J. Public Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"361","DOI":"10.2147\/CEOR.S134130","article-title":"The Economic and Humanistic Costs of Chronic Lower Back Pain in Japan","volume":"9","author":"Montgomery","year":"2017","journal-title":"Clinicoecon. Outcomes Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1002\/cncr.25761","article-title":"Cancer-Related Chronic Pain: Examining Quality of Life in Diverse Cancer Survivors","volume":"117","author":"Green","year":"2011","journal-title":"Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1007\/s11764-011-0172-z","article-title":"A Study of Chronic Pelvic Pain after Radiotherapy in Survivors of Locally Advanced Cervical Cancer","volume":"5","author":"Vistad","year":"2011","journal-title":"J. Cancer Surviv."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1016\/j.jpainsymman.2013.12.239","article-title":"Chronic Pain in Breast Cancer Survivors: Comparison of Psychosocial, Surgical, and Medical Characteristics between Survivors with and without Pain","volume":"48","author":"Smeby","year":"2014","journal-title":"J. Pain Symptom. Manage"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1001\/jamaoncol.2019.1439","article-title":"Prevalence of Chronic Pain and High-Impact Chronic Pain in Cancer Survivors in the United States","volume":"5","author":"Jiang","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"4310","DOI":"10.1002\/cncr.32450","article-title":"Prevalence of Chronic Pain among Cancer Survivors in the United States, 2010\u20132017","volume":"125","author":"Sanford","year":"2019","journal-title":"Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s11764-019-00843-0","article-title":"Chronic Pain, Health-Related Quality of Life, and Employment in Working-Age Cancer Survivors","volume":"14","author":"Borges","year":"2020","journal-title":"J. Cancer Surviv."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1177\/2049463720972730","article-title":"Chronic Pain, Functionality and Quality of Life in Cancer Survivors","volume":"15","author":"Veiga","year":"2021","journal-title":"Br. J. Pain"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1007\/s11764-022-01241-9","article-title":"Chronic Pain and Its Correlates among Long-Term Breast Cancer Survivors","volume":"17","author":"Yin","year":"2023","journal-title":"J. Cancer Surviv."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/j.1526-4637.2006.00220.x","article-title":"Chronic Pain in the Cancer Survivor: A New Frontier","volume":"8","author":"Burton","year":"2007","journal-title":"Pain Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s11764-013-0322-6","article-title":"Physical Activity Levels of Cancer Survivors in Canada: Findings from the Canadian Community Health Survey","volume":"8","author":"Neil","year":"2014","journal-title":"J. Cancer Surviv."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Alzahrani, H., Mackey, M., Stamatakis, E., Zadro, J.R., and Shirley, D. (2019). The Association between Physical Activity and Low Back Pain: A Systematic Review and Meta-Analysis of Observational Studies. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-44664-8"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e002426","DOI":"10.1136\/bmjdrc-2021-002426","article-title":"Association between Type 2 Diabetes and Chronic Low Back Pain in General Practices in Germany","volume":"9","author":"Jacob","year":"2021","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Yang, K., Liu, Z., Thong, M.S.Y., Doege, D., and Arndt, V. (2022). Higher Incidence of Diabetes in Cancer Patients Compared to Cancer-Free Population Controls: A Systematic Review and Meta-Analysis. Cancers, 14.","DOI":"10.3390\/cancers14071808"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3133","DOI":"10.1200\/JCO.2016.66.4391","article-title":"Trends in Obesity Prevalence in Adults With a History of Cancer: Results From the US National Health Interview Survey, 1997 to 2014","volume":"34","author":"Greenlee","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1097\/BSD.0000000000000468","article-title":"Obesity as a Risk Factor for Low Back Pain: A Meta-Analysis","volume":"31","author":"Zhang","year":"2018","journal-title":"Clin. Spine Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2731","DOI":"10.1097\/00007632-199512150-00015","article-title":"Psychologic Distress and Low Back Pain. Evidence from a Prospective Study in the General Population","volume":"20","author":"Croft","year":"1995","journal-title":"Spine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1002\/pon.614","article-title":"Cancer Survivorship and Psychological Distress in Later Life","volume":"11","author":"Deimling","year":"2002","journal-title":"Psychooncology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"459","DOI":"10.5414\/CP203320","article-title":"Basic Characteristics and Representativeness of the German Disease Analyzer Database","volume":"56","author":"Rathmann","year":"2018","journal-title":"Int. J. Clin. Pharmacol. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"16","DOI":"10.21037\/atm.2018.12.10","article-title":"Written on behalf of AME Big-Data Clinical Trial Collaborative Group Balance Diagnostics after Propensity Score Matching","volume":"7","author":"Zhang","year":"2019","journal-title":"Ann. Transl. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"114074","DOI":"10.1016\/j.ejca.2024.114074","article-title":"Skin Cancers Are the Most Frequent Cancers in Fair-Skinned Populations, but We Can Prevent Them","volume":"204","author":"Garbe","year":"2024","journal-title":"Eur. J. Cancer"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.jaad.2017.11.026","article-title":"All-Cause Mortality in Patients with Basal and Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis","volume":"78","author":"Wehner","year":"2018","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3322\/caac.21820","article-title":"Cancer Statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s11764-020-00854-2","article-title":"Comparison of Health Behaviours between Cancer Survivors and the General Population: A Cross-Sectional Analysis of the Lifelines Cohort","volume":"14","author":"Vinke","year":"2020","journal-title":"J. Cancer Surviv."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"246","DOI":"10.5993\/AJHB.27.3.6","article-title":"Do Adults Change Their Lifestyle Behaviors after a Cancer Diagnosis?","volume":"27","author":"Blanchard","year":"2003","journal-title":"Am. J. Health Behav."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"04152","DOI":"10.7189\/jogh.13.04152","article-title":"Association between Smoking and Incident Back Pain: A Prospective Cohort Study with 438\u2009510 Participants","volume":"13","author":"Xu","year":"2023","journal-title":"J. Glob. Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"197","DOI":"10.3399\/bjgp11X561195","article-title":"Primary Care Consultation Behaviours of Long-Term, Adult Survivors of Cancer in the UK","volume":"61","author":"Khan","year":"2011","journal-title":"Br. J. Gen. Pract."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"bjgpopen19X101663","DOI":"10.3399\/bjgpopen19X101663","article-title":"Exploring Why Patients with Cancer Consult GPs: A 1-Year Data Extraction","volume":"3","author":"Fidjeland","year":"2019","journal-title":"BJGP Open"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e919","DOI":"10.1097\/PR9.0000000000000919","article-title":"Prognostic Factors for Pain Chronicity in Low Back Pain: A Systematic Review","volume":"6","author":"Nieminen","year":"2021","journal-title":"Pain Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1097\/j.pain.0000000000001459","article-title":"A Complete National Cohort Study of Prescriptions of Analgesics and Benzodiazepines to Cancer Survivors in Norway 10 Years after Diagnosis","volume":"160","author":"Fredheim","year":"2019","journal-title":"Pain"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"112107","DOI":"10.1016\/j.nut.2023.112107","article-title":"Sarcopenia Prevalence in Patients with Cancer and Association with Adverse Prognosis: A Nationwide Survey on Common Cancers","volume":"114","author":"Zhang","year":"2023","journal-title":"Nutrition"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Iwahashi, S., Hashida, R., Matsuse, H., Higashi, E., Bekki, M., Iwanaga, S., Hara, K., Higuchi, T., Hirakawa, Y., and Kubota, A. (2022). The Impact of Sarcopenia on Low Back Pain and Quality of Life in Patients with Osteoporosis. BMC Musculoskelet. Disord., 23.","DOI":"10.1186\/s12891-022-05086-2"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Caetano Dos Santos, F.L., Wojciechowska, U., Michalek, I.M., and Didkowska, J. (2023). Survival of Patients with Cancers of the Female Genital Organs in Poland, 2000-2019. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-35749-6"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/1759-7714.15170","article-title":"Observed and Relative Survival Trends of Lung Cancer: A Systematic Review of Population-Based Cancer Registration Data","volume":"15","author":"Bi","year":"2024","journal-title":"Thorac. Cancer"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1001\/jamainternmed.2015.7431","article-title":"Prevention of Low Back Pain: A Systematic Review and Meta-Analysis","volume":"176","author":"Steffens","year":"2016","journal-title":"JAMA Intern. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e069908","DOI":"10.1136\/bmjopen-2022-069908","article-title":"Prevalence and Prognosis of Bone Metastases in Common Solid Cancers at Initial Diagnosis: A Population-Based Study","volume":"13","author":"Zhang","year":"2023","journal-title":"BMJ Open"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/22\/6969\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:35:18Z","timestamp":1760114118000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/22\/6969"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,19]]},"references-count":44,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["jcm13226969"],"URL":"https:\/\/doi.org\/10.3390\/jcm13226969","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2024,11,19]]}}}