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PAIN CONTROL AMONG CANCER SURVIVORS IN OHIO 2010
Robert W. Indian, ChiefMary Lynn, Researcher
Debbie Wallace, Administrative AssistantComprehensive Cancer Control Program
Office of Healthy OhioOhio Department of Health
Presented at:2011 CDC National Comprehensive
Cancer Project Directors’ ConferenceMay 3-5, Atlanta, Georgia
INTRODUCTION:
•The Core Values and Goals of Medicine Emphasize the Relief of Pain and Suffering as a Pre-eminent Responsibility of Physicians.
•Pain Management Presents a Glaring Example of Disparity Between the Current State of Medical Knowledge and the Prevailing Custom of Medical Practice.
Source: Ben Rich, PhD, J.D. “An Ethnical Analysis of the Barriers to Effective Pain Management”, 2009.
OBJECTIVE:
Provide a Reliable Estimate of the Prevalence of Pain and Pain Control Among Ohio Cancer Patients Age 19 Years and Older.
METHODS
• Data Source: “Cancer Survivorship” Module in 2010 Ohio Behavioral Risk Factor Survey.
• Focus on Question:
“Do you currently have physical pain caused by your cancer or cancer treatment?”
METHODS (cont’d)
• Prevalence Percentages and 95% Confidence Intervals (CIs) Calculate Using SAS version 9.2 (SAS Institute, Inc., Cary, North Carolina)
• Cross Tabulated by Gender, Age, Cancer Site/Type, Insurance Status, Type of Physician, Participation in Clinical Trial, and Receiving Instructions on Where to Go for Follow-up Care.
RESULTS: SAMPLE
• 2010 Ohio Total Sample: 9,857 Persons Age 19 and Older.
• 2010 “Ever Been Diagnosed With Cancer”: 1,107 (11.2%)
RESULTS: GENDER
Current Cancer Pain
Gender Est. Percent 95% C.I.•Male 4.9% 1.4 – 8.5•Female 11.7% 8.5 – 14.9•Total 9.1% 6.7 – 11.5
Conclusions: Females More Likely to Experience Pain.
Source: 2010 Ohio BRFSS; Comprehensive Cancer Control Program; Office of Healthy Ohio, Ohio Department of Health.
RESULTS: AGECurrent Cancer Pain
Age Group (years) Estimate Percent (%) 95% CI•18-44 11.8% 4.2-19.4•45-54 15.1% 6.5-23.6•55-64 11.5% 6.1-16.8•65 and older 5.2% 2.9-7.5
Conclusion: Cancer Survivors Age 65 and Older Less Likely to Report Current Cancer Pain.
Source: 2010 Ohio BRFSS; Comprehensive Cancer Control Program; Office of Healthy Ohio, Ohio Department of Health.
RESULTS: CANCER SITE/TYPE
CURRENT CANCER PAIN
Cancer Type/Site Estimated Prevalence 95% CI•Breast 15.4% 8.9-22.0•Cervical 12.2% 3.1-21.4•Colorectal 9.3% 2.1-16.4•Prostate 6.9% 0.0-14.9•Melanoma 0.5% 0.0-1.3•Other Skin 1.5% 0.0-3.2
Conclusion: Breast Cancer Survivors Most Likely to Report Current Pain.
Source: 2010 Ohio BRFSS; Comprehensive Cancer Control Program; Office of Healthy Ohio, Ohio Department of Health.
RESULTS: INSURANCE STATUS
CURRENT CANCER PAIN
Insurance Status Estimated Prevalence 95% C.I.•Had Health Insurance 8.6% 6.2-11.1•No Health Insurance 19.6% 5.9-33.2
Conclusion: Persons without Health Insurance More Likely to Report Current Cancer Pain.
Source: 2010 Ohio BRFSS; Comprehensive Cancer Control Program; Office of Healthy Ohio, Ohio Department of Health.
RESULTS: PHYSICIAN TYPE
CURRENT CANCER PAIN
Physician Type Estimated Prevalence (%) 95% CI•Cancer Specialist 16.7% 7.1-26.3•Family Practice 7.5% 4.8-10.2•Internist 5.8% 1.4-10.2•Other 11.2% 4.4-18.0
Conclusion: Cancer Survivors still in Contact with Cancer Specialist Most Likely to Report Current Cancer Pain
Source: 2010 Ohio BRFSS; Comprehensive Cancer Control Program; Office of Healthy Ohio, Ohio Department of Health.
RESULTS: PARTICIPATED IN CLINICAL TRIAL
CURRENT CANCER PAIN
Participation In EstimatedClinical Trial Prevalence %C.I.•Yes 20.1% 1.5-38.7•No 7.8% 5.7-9.9
Conclusion: The Survivors Reporting Having Participated In a Clinical Trial Were More Likely to Report Current Cancer Pain.
Source: 2010 Ohio BRFSS; Comprehensive Cancer Control Program; Office of Healthy Ohio, Ohio Department of Health.
RESULTS: RECEIVED FOLLOW-UP INSTRUCTIONS
CURRENT CANCER PAIN
Received Follow-Up EstimatedInstructions Prevalence 95% CI•Yes 11.5% 8.1-14.9•No 4.4% 1.7-7.1
Conclusion: Those Survivors Receiving Follow-up Instructions Reported More Current Cancer Pain.
Source: 2010 Ohio BRFSS; Comprehensive Cancer Control Program; Office of Healthy Ohio, Ohio Department of Health.
DISCUSSION/LIMITATIONS
• Self Reported Data
• Small Sample Sizes/Large Confidence Intervals
• Could Benefit from Meta-Analysis
MANY THANKS
• American Cancer Society - $$ Funding $$
• Ohio Behavioral Risk Factor Surveillance System – Inclusion of Cancer Survival Module
• Constantino Benedetti, M.D., The Ohio State University Medical Center – Inspiration and Dedication to Pain Control for Cancer Patients
QUESTIONS?
Robert W. Indian, M.S.Chief, Comprehensive Cancer Control Program
Bureau of Health Promotion and Risk ReductionOffice of Healthy Ohio
Ohio Department of Health246 N. High Street
Columbus, Ohio 43215(614) 752-2464
