Rutgers New Jersey Medical School, Newark, NJ
Marco Santos Teles , Ganesh Modugu , Isabel C. Silva , Raj Malhotra , Munir Rahbe , Mariam F. Eskander
Background: Cancer survivors often suffer from chronic pain. However, not all patients have access to medication and other pain management strategies, making pain control challenging. We aim to determine the association of sociodemographic factors with self-reported pain control in cancer survivors with cancer-related chronic pain. Methods: A cross-sectional analysis was conducted using data from the 2022 Behavioral Risk Factor Surveillance System survey. Cancer survivors who self-reported physical pain from cancer or treatment were included. Non-melanoma skin cancer survivors were excluded. The outcome of interest was pain control. Univariate analysis with chi-square and multivariable logistic regression were used to determine the sociodemographic characteristics associated with pain control. Models were adjusted for age, sex, marital status, income, insurance coverage, BMI, smoking status, and cancer site. Results: 1,670 cancer survivors with self-reported cancer-related chronic pain were identified. 9.2% were aged < 40, 61.5% were female, and 71.6% were non-Hispanic white. 97.2% were insured, 50.5% earned ≥ $50,000, and 27.6% were college graduates. 29.8% of survivors reported a history of breast cancer, followed by melanoma (6.3%), and lung cancer (6.1%). Young adults (age 18-39) reported significantly lower pain control compared to older survivors (52% vs. 77.7%, p <0.001). Non-Hispanic Black survivors reported the highest rates of pain control, followed by non-Hispanic white, and Hispanic survivors (87.7% vs. 77.5% vs. 60.6%, respectively, p= 0.013). Employed survivors reported significantly higher pain control than those out of the workforce (83.2% vs. 73.7%, p= 0.008, respectively). College graduates reported better pain control than those without a college degree (82.9% vs. 74.7%, p=0.009, respectively). There was no significant association between pain control and insurance coverage or income. On multivariate analysis, young adults had lower pain control than older adults (OR: 0.454; 95% CI: 0.219-0.942). Compared to non-Hispanic white survivors, being Hispanic was associated with worse pain control (OR: 0.324; 95% CI: 0.142-0.737); no significant association was found for non-Hispanic Black survivors (OR: 1.964; 95% CI: 0.851-4.631). Employment was associated with better pain control (OR: 1.997; 95% CI: 1.235-3.231). College degree attainment was not significantly associated with pain control on multivariate analysis (OR: 1.414; 95% CI: 0.934-2.142). Conclusions: Age, race/ethnicity and employment were associated with pain control among cancer survivors. Young adults, Hispanic and unemployed survivors were most likely to have poor pain control. Further research should elucidate the factors driving these relationships in order to achieve more equitable pain management in this population.
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