[FOR EMBARGOED RELEASE Wednesday, April 7]
Contact: Kevin Stein, 404.982.3640 (w); 678.596.6157 (cell)

Racial/Ethnic Disparities in the Management of Cancer Pain: Implications for Practice, Research, and Health Care Policy

SEATTLE, WA - Blacks, Latinos, and other minority groups report higher levels of cancer-related pain and more barriers to pain management compared to whites. These racial disparities, however, may be attributable to differences in neighborhood segregation and economic deprivation rather than race, according to results from a large study of cancer survivors conducted by the American Cancer Society’s Behavioral Research Center. The findings come from the Study of Cancer Survivors, and will be presented at the Society of Behavioral Medicine’s Annual Meeting in Seattle this week.

For this study, investigators recruited a racially and geographically diverse sample of more than16,000 survivors of the most highly incident cancers using SEER and NPCR statewide cancer registries in 21 different states across the country. The study includes both longitudinal and cross-sectional components, with cancer survivors recruited at about one-year post diagnosis being followed for up to 10 years in the longitudinal component and separate cohorts of 2, 5, and 10-year survivors providing single-time cross-sectional data to allow for the investigation of differences in time-since-diagnosis in a more timely fashion than afforded by following a cohort over time.

The present results demonstrate that Black and Latino cancer survivors report more barriers to the management of cancer-related pain; in particular, being a minority was a significant predictor for 11 of the 15 pain management barriers assessed in our study. Black survivors also reported higher levels of current bodily pain than did White survivors. However, multi-level analyses that included individual (e.g. age, gender, and race) and area-level (county poverty and segregation) variables found that race was no longer significant whereas segregation, poverty, and other individual-level predictors remained. This finding is consistent with previous research that has shown that compared to White neighborhoods of matched socioeconomic status, segregated Black neighborhoods have lower quality health care facilities, fewer specialists (e.g. oncologists, pain management specialists), and fewer pharmacies that stock opioid analgesics. Such neighborhood differences likely play a role in poor management of pain in cancer survivors who reside in segregated areas.

Kevin Stein, PhD, Director of Quality of Life and Survivorship Research for the American Cancer Society, along with Tenbroeck Smith, MA and Rebecca Kirch, JD, with the American Cancer Society’s Behavioral Research Center and Cancer Action Network (ACS CAN), respectively, will highlight the research and policy implications of the study’s results, while Gloria Juarez, RN, PhD, Assistant Professor at the City of Hope in Los Angeles will serve as the discussant and address clinical implications. The goal of the symposium is to bring together cancer researchers, policy advocates, and clinicians to discuss racial differences in pain and pain management. Multi-level analyses, considering individual and area level variables, will show the explanatory power of neighborhood deprivation on pain disparities. The symposium will identify future directions for research and clinical practice as well as address policy and advocacy activities.

“These results not only advance our understanding of the factors that contribute to health disparities between cancer survivors of differing racial and ethnic backgrounds, but also identify avenues for community interventions and advocacy around policy change that may help decrease such disparities,” said Dr. Stein. “While the roles of area segregation and poverty in general health disparities are well established, this is the first time these variables have been considered in the investigation of disparities in cancer-related pain.”

Results from the ACS Studies of Cancer Survivors have produced a total of 37 publications to date, as well as more than 90 scientific presentations at national and international conferences. The findings have also been used by state cancer control planners and by the American Cancer Society to improve and develop informational and supportive services to people affected by cancer.

In addition to the 4 presenting authors, co-authors of the current symposium on racial and ethnic disparities in cancer pain and pain management include Hope Landrine, PhD, Director of Multi-Cultural Research, American Cancer Society; Carmen Greene, MD, Associate Professor, Department of Anesthesiology University of Michigan; Chiewkwei Kaw, MS, Research Analyst, American Cancer Society; Yongping Hao, PhD, Biostatistician, Centers for Public Health Research and Evaluation, Battelle; and Katherine Sharpe, Managing Director, Prevention and Survivorship, American Cancer Society.

The Society of Behavioral Medicine is a multidisciplinary organization of clinicians, educators and scientists dedicated to promoting the study of the interactions of behavior with biology and the environment and the application of that knowledge to improve the health and well being of individuals, families, communities and populations.
www.sbm.org

Editor’s notes:
This study was presented during the 2010 Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine (SBM) from April 7-10 in Seattle, Washington. However, it does not necessarily reflect the policies or the opinion of the SBM.

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