Abstract B025: Examining the role of perceived respect on racial disparities in cancer-related pain

Background: Black cancer patients consistently report worse pain management than White patients. Effective pain management requires communication, and provider respect is linked to positive provider-patient communication. Racial differences in patient perceptions of respect during clinical encounters are well documented and linked to disparities in care, yet little is known about whether racial differences in perceived respect contribute to disparities in cancer pain. As part of the NCI-funded study, Accountability for Cancer Care through Undoing Racism and Equity, we examined whether perceived respect was associated with racial disparities in pain. Methods: We obtained prospective survey data from Black and White breast and lung cancer patients in active treatment at two cancer centers from 2013-2017. The primary outcome was a binary measure of moderate-to-severe pain based on patient responses to PROMIS items 90 days post-diagnosis. A binary measure of “high” vs “low” respect was computed based on patient responses to a survey item assessing perceived respect from doctors at the last clinic visit. We estimated logistic regressions assessing associations between race and pain 90 days post-diagnosis and the mediating effect of respect, adjusting for patient demographics, baseline pain, clinical characteristics, and site of care. Results: Compared with Whites (N = 200), Blacks (N = 119) were more likely to report moderate-to-severe pain (26.9% vs. 49.1%; p