title: Pain in underserved community-dwelling Chinese American cancer patients: demographic and medical correlates.
abstract: BACKGROUND
  Little is known about cancer pain in Chinese Americans. The objective of this study was to describe the epidemiology of pain in this population. This information is needed to identify and address unmet clinical needs for culturally relevant interventions targeting pain and its consequences.
  
  
  METHODS
  A consecutive sample of underserved ethnic Chinese patients in a large community-based oncology practice was screened for persistent or frequent pain. Those patients with pain completed translated instruments assessing demographics, linguistic acculturation, disease-related characteristics, and pain-related characteristics.
  
  
  RESULTS
  Of 312 patients screened, 178 (57.1%) reported frequent or persistent pain, 175 were eligible, and 170 participated. Most participants (85.9%) were born in China and 84.7% overall spoke Cantonese only. The most common cancers were gastrointestinal (28.2%), lung (21.8%), breast (20.6%), head and neck (12.9%), and genitourinary (4.7%); 43.5% had metastatic disease. The mean worst pain severity on a 0-10 numeric scale was 4.7 (standard deviation, 2.4), with 28.2% of patients rating their worst pain at ≥7 of 10. Although 37.6% used opioids and 47.1% used nonopioids, 45.8% reported "little" or "no" pain relief from medications. Complementary or alternative medicine therapies for cancer pain were used by 35.8%. In multiple regression analyses, worst pain was positively associated with acculturation to the English language and opioid therapy, and pain-related distress was positively associated with opioid therapy.
  
  
  CONCLUSIONS
  Pain is prevalent among community-dwelling, ethnic Chinese American cancer patients. Additional studies are needed to confirm these results and investigate the finding that higher linguistic acculturation is associated with reports of more intense pain.
authors.affiliation: Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, 120 East 16th Street, 12th Floor, New York, New York 10003, USA. Ldhingra@chpnet.org
authors.forename: Lara
authors.initials: L
authors.lastname: Dhingra
authors.forename: Kin
authors.initials: K
authors.lastname: Lam
authors.forename: Peter
authors.initials: P
authors.lastname: Homel
authors.forename: Jack
authors.initials: J
authors.lastname: Chen
authors.forename: Victor T
authors.initials: VT
authors.lastname: Chang
authors.forename: Juanyi
authors.initials: J
authors.lastname: Zhou
authors.forename: Selina
authors.initials: S
authors.lastname: Chan
authors.forename: Wan Ling
authors.initials: WL
authors.lastname: Lam
authors.forename: Russell
authors.initials: R
authors.lastname: Portenoy
mesh_terms: D001213:Asian; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D009369:Neoplasms / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology*; D010146:Pain / Q000150:complications / Q000188:drug therapy / Q000208:ethnology*; D010147:Pain Measurement; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations