Background Cancer-related pain is a significant and debilitating problem. Non-pharmacological treatments such as acupuncture may have an adjunctive role in controlling pain without the undesirable side effects of drug regimens and yet the evidence base remains limited.

Objectives The main objective of this systematic review was to evaluate the effectiveness of acupuncture in the management of cancer-related pain in adults. Subgroup analyses were planned for acupuncture dose and for the outcome of studies investigating acupuncture for cancer-induced bone pain.

Methods Six electronic databases were searched, including the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, AMED and SPORTDiscus. Studies included in the review were randomised controlled trials investigating the use of acupuncture for cancer pain using pain as a primary outcome measure. In total, 253 published references were identified but only three studies met the inclusion criteria and were included in the final review.

Results Of the three included studies, only one was judged to be of high methodological quality and showed auricular acupuncture to be superior to placebo acupuncture and ear seeds at placebo points. However, the study was relatively small and blinding was compromised. The two low-quality studies gave positive results in favour of acupuncture for cancer pain, but these results should be viewed with caution due to methodological limitations, small sample sizes, poor reporting and inadequate analysis.

Conclusion There is insufficient evidence to judge whether acupuncture is effective in treating cancer pain in adults.