Pain and treatment of pain in minority patients with cancer. The Eastern Cooperative Oncology Group Minority Outpatient Pain Study

Ann Intern Med. 1997 Nov 1;127(9):813-6. doi: 10.7326/0003-4819-127-9-199711010-00006.


Background: Clinics that primarily see members of ethnic minority groups have been found to provide inadequate treatment of cancer-related pain. The extent of undertreatment of pain in these patients and the factors that contribute to undertreatment are not known.

Objectives: To evaluate the severity of cancer-related pain and the adequacy of prescribed analgesics in minority outpatients with cancer.

Design: Prospective clinical study.

Setting: Eastern Cooperative Oncology Group.

Patients: 281 minority outpatients with recurrent or metastatic cancer.

Measurements: Patients and physicians independently rated severity of pain, pain-related functional impairment, and pain relief obtained by taking analgesic drugs. Analgesic adequacy was determined on the basis of accepted guidelines.

Results: 77% of patients reported disease-related pain or took analgesics; 41% of patients reporting pain had severe pain. Sixty-five percent of minority patients did not receive guideline-recommended analgesic prescriptions compared with 50% of non-minority patients (P < 0.001). Hispanic patients in particular reported less pain relief and had less adequate analgesia.

Conclusions: The awareness that minority patients do not receive adequate pain control and that better assessment of pain is needed may improve control of cancer-related pain in this patient population.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care
  • Analgesics / therapeutic use*
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Minority Groups*
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local / complications
  • Neoplasms / complications*
  • Neoplasms / ethnology*
  • Pain / drug therapy*
  • Prospective Studies


  • Analgesics