Cancer pain often undertreated, especially among minorities

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One-third of ambulatory patients with invasive cancer of the breast, prostate, colon/rectum, or lung were found to be receiving insufficient pain treatment, with members of minority groups being twice as likely as non-Hispanic white patients to experience this.

A total of 3,123 oncology outpatients at 38 institutions nationwide, at various stages of disease and phases of care, were enrolled in a prospective study designed to evaluate pain management in this population. Of the 3,023 patients identified to be at risk for pain, 2,026 (67%) reported having pain or requiring analgesics when initially assessed by the researchers. One-third (670 patients, or 33%) of that subset were found to be receiving inadequate analgesic prescribing.

Non-Hispanic white patients were approximately half as likely as Hispanic, black, Asian, and other minority patients to receive inadequate pain treatment. Other significant predictors of inadequate pain treatment were: having a good performance status, being treated at a minority treatment site, and having nonadvanced disease without concurrent treatment. These findings persisted over 1 month of follow-up.

“There is significant disparity in pain treatment adequacy, with the odds of undertreatment twice as high for minority patients,” summarized senior study author Charles S. Cleeland, PhD, of the University of Texas M. D. Anderson Cancer Center in Houston, and colleagues in their report for Journal of Clinical Oncology.

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