To improve the quality of pain management in cancer patients, clinical guidelines have been published and revised around the world. Whereas, there are large gaps in evidence-based resources across cancer pain management guidelines, and there is an urgent need for high-quality systematic evaluation of guidelines to bridge the practice gap.

To systematically review the relevant guidelines for treating cancer pain patients, analyze the similarities and differences between the recommendations of each guide, and provide an evidence-based decision reference for clinical practice.

A systematic search of PubMed, Web of Science, Cochrane Library, CNKI, Wanfang Data, CBM, BP, SIGN, NGC, Medical Communication, and the websites of relevant societies and industry bodies for guidelines on the management of patients with cancer pain was performed. The search timeframe was from the construction of the database to October 9, 2023. The literature was screened by two investigators according to the inclusion and exclusion criteria, and the guidelines were evaluated for quality using the Appraisal of Guidelines for Research & EvaluationⅡ (AGREE Ⅱ) to summarise the recommendations of each guideline related to managing pain in cancer patients.

Seven guidelines were ultimately included, developed for the period 2016-2023, including two from the United States, two from Switzerland, one from Canada, one from Latin America, and one from Japan, all with guideline recommendation level A. The related recommendations were mainly focused on 4 aspects: cancer pain assessment, pharmacological management, non-pharmacological management, and cancer pain education.

The recommendations of the 7 guidelines can provide a new reference for the practice of cancer pain management in China. It is suggested that clinical practitioners should consider the specific conditions of patients and work with multidisciplinary cooperation to truly achieve the "5A" goal of cancer pain management.

为了提高癌症患者疼痛管理的质量，世界各地已经出版和修订了临床指南，但各癌性疼痛管理指南循证资源差距大，亟需高质量的指南系统评价弥补实践差距。

通过系统评价癌性疼痛患者管理的相关指南，分析各指南推荐意见的异同，为临床提供循证决策参考。

系统检索PubMed、Web of Science、Cochrane Library、中国知网、万方数据知识服务平台、中国生物医学文献数据库、BMJ最佳临床实践、苏格兰校际指南网络、美国国立指南数据库、医脉通以及相关学会和行业机构网站中关于癌性疼痛患者的管理指南，检索时限为建库至2023-10-09。由2名研究者根据纳入与排除标准筛选文献，并采用指南研究与评价工具Ⅱ（AGREE Ⅱ）对指南进行质量评价，汇总各指南在癌症患者疼痛管理中的相关推荐意见。

最终纳入7篇指南，制订时间为2016—2023年，其中美国2篇，瑞士2篇、加拿大1篇、拉丁美洲1篇和日本1篇，指南推荐级别均为A级。相关推荐意见主要围绕癌性疼痛评估、药物管理、非药物管理、癌性疼痛教育4个方面展开。

7篇指南的推荐意见可为我国癌性疼痛管理实践提供新的参考依据，建议临床实践者要结合患者的具体情况，多学科合作共同探讨，以真正实现癌性疼痛管理的"5A"目标。