Is race/ethnicity related to the presence or severity of pain in colorectal and lung cancer?

Kathryn A. Martinez, Claire Snyder, Jennifer L. Malin, Sydney E Dy

Research output: Contribution to journalArticle

Abstract

Context Developing interventions to address racial/ethnic cancer pain disparities requires exploration of the role of socioeconomic status, health status, and pain severity from the time of diagnosis. Objectives To examine patterns of disparities in cancer pain by evaluating differences by race/ethnicity in the odds of reporting pain and in pain severity, controlling for key patient-level covariates. Methods This study used data from a nationally representative cohort of colorectal and lung cancer patients. Multivariable logistic regression was conducted to examine the relationship between race/ethnicity and reporting pain. Multivariable linear regression was then conducted, among those who reported pain, to determine differences in pain severity by race/ethnicity. Results The cohort included 5761 individuals (14% black, 7% Hispanic/Latino, 6% Asian or Pacific Islander, and 3% multiracial), among whom 48% reported pain. The adjusted odds of reporting differed only for multiracial patients, who were more likely to report pain than whites (odds ratio: 1.54; P = 0.036). However, among those with pain, severity was higher for black patients (β = 6.6; P ≤ 0.001) and multiracial patients (β = 4.5; P = 0.036) relative to white patients. Lower educational attainment, depressed affect, and lower levels of wealth also were associated with higher pain severity. Conclusion Although the odds of experiencing pain differed only for multiracial patients, among those reporting pain, both blacks and multiracial individuals reported higher pain severity than whites. Sociodemographic status, health status, and depression were associated with severity but did not explain the disparity. Interventions to address these disparities will need to focus on reported severity and patient-level factors.

Original languageEnglish (US)
Pages (from-to)1050-1059
Number of pages10
JournalJournal of Pain and Symptom Management
Volume48
Issue number6
DOIs
StatePublished - Dec 1 2014

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Colorectal Neoplasms
Lung Neoplasms
Pain
Hispanic Americans
Health Status
Social Class
Linear Models
Logistic Models
Odds Ratio
Depression

Keywords

  • Cancer pain
  • colorectal cancer
  • health disparities
  • lung cancer
  • patient-reported outcomes
  • quality of life

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology
  • Nursing(all)

Cite this

Is race/ethnicity related to the presence or severity of pain in colorectal and lung cancer? / Martinez, Kathryn A.; Snyder, Claire; Malin, Jennifer L.; Dy, Sydney E.

In: Journal of Pain and Symptom Management, Vol. 48, No. 6, 01.12.2014, p. 1050-1059.

Research output: Contribution to journalArticle

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abstract = "Context Developing interventions to address racial/ethnic cancer pain disparities requires exploration of the role of socioeconomic status, health status, and pain severity from the time of diagnosis. Objectives To examine patterns of disparities in cancer pain by evaluating differences by race/ethnicity in the odds of reporting pain and in pain severity, controlling for key patient-level covariates. Methods This study used data from a nationally representative cohort of colorectal and lung cancer patients. Multivariable logistic regression was conducted to examine the relationship between race/ethnicity and reporting pain. Multivariable linear regression was then conducted, among those who reported pain, to determine differences in pain severity by race/ethnicity. Results The cohort included 5761 individuals (14{\%} black, 7{\%} Hispanic/Latino, 6{\%} Asian or Pacific Islander, and 3{\%} multiracial), among whom 48{\%} reported pain. The adjusted odds of reporting differed only for multiracial patients, who were more likely to report pain than whites (odds ratio: 1.54; P = 0.036). However, among those with pain, severity was higher for black patients (β = 6.6; P ≤ 0.001) and multiracial patients (β = 4.5; P = 0.036) relative to white patients. Lower educational attainment, depressed affect, and lower levels of wealth also were associated with higher pain severity. Conclusion Although the odds of experiencing pain differed only for multiracial patients, among those reporting pain, both blacks and multiracial individuals reported higher pain severity than whites. Sociodemographic status, health status, and depression were associated with severity but did not explain the disparity. Interventions to address these disparities will need to focus on reported severity and patient-level factors.",
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