pain control among cancer survivors in ohio 2010 robert w. indian, chief mary lynn, researcher...
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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
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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.
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OBJECTIVE:
Provide a Reliable Estimate of the Prevalence of Pain and Pain Control Among Ohio Cancer Patients Age 19 Years and Older.
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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?”
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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.
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RESULTS: SAMPLE
• 2010 Ohio Total Sample: 9,857 Persons Age 19 and Older.
• 2010 “Ever Been Diagnosed With Cancer”: 1,107 (11.2%)
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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DISCUSSION/LIMITATIONS
• Self Reported Data
• Small Sample Sizes/Large Confidence Intervals
• Could Benefit from Meta-Analysis
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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
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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