ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2023
Racial and Ethnic Disparities in Opioid Access and Urine Drug Screening Among Older Patients With Poor-Prognosis Cancer Near the End of Life.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- Ethnic inequalities in palliative care prescribing in high income countries - a rapid systematic review.BMC palliative care · 2025Pooled it
- MyPainPal, a Novel mHealth App to Improve Pain in Patients With Advanced Cancer: Single-Arm Pilot Study.JMIR cancer · 2025Trial
- Urine Drug Testing Among Long-term Opioid Prescribed Patients: Disparities and Opportunities.Journal of racial and ethnic health disparities · 2026Article
- Caregiver Availability and Racial Differences in End-Of-Life Care Quality: Evidence From the National Health and Aging Trends Study 2017-2024.Journal of the American Geriatrics Society · 2026Article
- Impact of Hydrocodone Rescheduling on Pharmaceutical Pain Management in End-of-Life Lung Cancer Patients.Journal of palliative care · 2026Article
- Racial and ethnic differences in opioid fills following cancer-directed surgery among older and younger Medicare beneficiaries.Journal of the National Cancer Institute · 2026Article
- Evaluating risk factors and protective clinical interventions for opioid use disorder and overdose in American Indian/Alaska Native populations.Journal of ethnicity in substance abuse · 2026Article
- Pain Disparities Among Asian Americans Affected by Cancer: The Role of Depressive Symptoms.Journal of palliative medicine · 2026Article
- Article
- Prescription Monitoring Program Mandates and Opioids Dispensed to Patients Dying of Cancer.JCO oncology practice · 2026Article
- Racial and Ethnic Disparities in Pharmacologic and Non-Pharmacologic Pain Management Among Older Cancer Survivors.Cancer medicine · 2026Article
- Patient-centred educational interventions for assessing and managing cancer-related pain relevant to minority ethnic populations: A mixed-methods systematic review.Palliative care and social practice · 2026Review
- Disparities in Prescription Opioids Among a National Sample of Adult Cancer Patients 2012-2021.Journal of racial and ethnic health disparities · 2025Article
- Trends in Outpatient Opioid Prescriptions for Cancer Pain Between 2016 and 2021.JCO oncology practice · 2025Article
- Patient-Physician Messaging by Race, Ethnicity, Insurance Type, and Preferred Language.JAMA network open · 2025Article
- Disparities Among Asian and Black Patients with Cancer in Receipt of Palliative Care in a Single Urban Academic Cancer Center.Journal of palliative medicine · 2025Article
- "I don't tell anyone I have them:" Experiences with opioid stigma from the perspective of survivors living with chronic cancer-related pain and clinicians that care for them.The journal of pain · 2025Article
- Palliative Care Specialist Use Among Medicare Decedents Who Had Poor-Prognosis Cancers.JAMA network open · 2025Article
- Prevalence of cannabis and medication use by indices of residential urbanicity and deprivation among Ohio cancer patients.Cancer causes & control : CCC · 2025Article
- Racial Disparities in Analgesic and Psychiatric Medication Use During End-Of-Life Care in Advanced-Stage Colorectal Cancer: A Retrospective Cohort Study.Cancer research communications · 2025Observational
Corrections and comments
- Commented on by
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
purposeTo characterize racial and ethnic disparities and trends in opioid access and urine drug screening (UDS) among patients dying of cancer, and to explore potential mechanisms.
methodsAmong 318,549 non-Hispanic White (White), Black, and Hispanic Medicare decedents older than 65 years with poor-prognosis cancers, we examined 2007-2019 trends in opioid prescription fills and potency (morphine milligram equivalents [MMEs] per day [MMEDs]) near the end of life (EOL), defined as 30 days before death or hospice enrollment. We estimated the effects of race and ethnicity on opioid access, controlling for demographic and clinical factors. Models were further adjusted for socioeconomic factors including dual-eligibility status, community-level deprivation, and rurality. We similarly explored disparities in UDS.
resultsBetween 2007 and 2019, White, Black, and Hispanic decedents experienced steady declines in EOL opioid access and rapid expansion of UDS. Compared with White patients, Black and Hispanic patients were less likely to receive any opioid (Black, -4.3 percentage points, 95% CI, -4.8 to -3.6; Hispanic, -3.6 percentage points, 95% CI, -4.4 to -2.9) and long-acting opioids (Black, -3.1 percentage points, 95% CI, -3.6 to -2.8; Hispanic, -2.2 percentage points, 95% CI, -2.7 to -1.7). They also received lower daily doses (Black, -10.5 MMED, 95% CI, -12.8 to -8.2; Hispanic, -9.1 MMED, 95% CI, -12.1 to -6.1) and lower total doses (Black, -210 MMEs, 95% CI, -293 to -207; Hispanic, -179 MMEs, 95% CI, -217 to -142); Black patients were also more likely to undergo UDS (0.5 percentage points; 95% CI, 0.3 to 0.8). Disparities in EOL opioid access and UDS disproportionately affected Black men. Adjustment for socioeconomic factors did not attenuate the EOL opioid access disparities.
conclusionThere are substantial and persistent racial and ethnic inequities in opioid access among older patients dying of cancer, which are not mediated by socioeconomic variables.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.