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This study investigated the prevalence and causes of pain at the early stages of cancer.Design and patients: A total of 378 newly diagnosed (0–6 months from diagnosis) unselected cancer patients were asked to respond to a questionnaire on pain and other symptoms;240 patients (64%) answered. Of these, 66 patients (28%) reported pain and were examined in the pain clinic. Thirty patients had pain caused by direct tumor growth, and 44 had pain secondary to cancer or its treatment. In 12 of 66 patients, the pain was unrelated to cancer. Fifteen patients had two or more different types of pain simultaneously.Conclusion: The results of this study indicate that awareness of pain and its management at early stages of cancer are essential.