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Advanced age did not correlate with inadequate cancer pain management in Italy. However, geographic location impacted older patients, while assessment timing affected younger patients, highlighting age-specific challenges in pain control.

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Area of Science:

  • Oncology
  • Pain Management
  • Geriatrics

Background:

  • Previous research suggests a link between older age and insufficient cancer pain management.
  • Italy's aging population presents a unique setting to re-evaluate this association.

Purpose of the Study:

  • To assess the impact of advanced age on pain management adequacy in Italian radiotherapy patients.
  • To identify age-specific factors contributing to analgesic undertreatment.

Main Methods:

  • Prospective, multicenter study of 2104 patients in Italian radiotherapy centers.
  • Pain intensity measured by Numeric Rating Scale (NRS); adequacy by Pain Management Index (PMI).
  • Statistical analysis included LASSO regression and Classification and Regression Tree (CART) analysis, with separate age group analyses.

Main Results:

  • Overall, 42% of patients experienced undertreatment (PMI < 0), with no significant age difference (older: 41.0%, younger: 43.1%).
  • Non-cancer pain (74.3%) and curative radiotherapy (49.4%) were associated with higher undertreatment rates.
  • Older patients showed geographic disparities in undertreatment (central/southern Italy higher than north); younger patients were influenced by assessment timing.

Conclusions:

  • Advanced age was not independently associated with inadequate analgesia in this Italian cohort.
  • Determinants of inadequate pain management varied by age: geographic disparities for older adults, assessment timing for younger adults.
  • Age-dependent interventions are needed to address disparities in cancer pain management.