471: Organizational barriers to pain management in cancer treatment

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic cancer related pain, Treatment/management

Background and Aims: Advancements in diagnostic imaging have significantly improved early cancer detection and treatment outcomes, leading to increased survival rates (WHO, 2018; Siegel RL, 2019). However, this progress has also resulted in heightened pain experiences among cancer patients (Marieke H., 2018; World Cancer Report, 2020). Insufficient knowledge among healthcare providers and systemic barriers within the healthcare system contribute to this issue (Li Z., 2018). Given that pain is a common and complex symptom during cancer treatment (M. Evenepoel, 2022), addressing the barriers to effective pain management is crucial.
Aims: This research aims to identify barriers to pain management in cancer treatment and develop preventive measures.
Objectives:
Compare and characterize cancer incidence in Georgia between 2008 and 2015-2019.
Assess the frequency, intensity, prescribed analgesics, and outcomes of pain experienced by cancer patients.
Identify patient-associated barriers to pain management.
Identify physician-associated barriers to pain management.
Identify barriers associated with the regulation of medical opioid use.

Methods: To determine the incidence and barriers to pain management during cancer treatment, the following issues need to be studied: Determining cancer incidence using a population-based cancer registry database;
Researching the results of pain assessment and management during cancer treatment from medical records and verifying the data obtained by surveying the same patients;
Surveying patients during cancer treatment to determine the incidence, assessment, management, and family influence of pain, their attitude to opioid management, and other issues;
Analysis of the regulatory documents currently in force for medical opioids in Georgia.

Results: In 2015-2019, according to crude rates, 258 men per 100,000 in Georgia were diagnosed with cancer annually. In 2015-2019, according to age-standardized (ASR) rates, 183 men per 100,000 in Georgia were diagnosed with cancer annually.

The first place in terms of cancer locations is lung cancer (ASR=27.3), II - prostate (ASR=20.4), III - bladder (ASR=16.0), IV - colorectum (ASR=15.8), V - skin (ASR=14.8).

According to age-adjusted (AAR) rates, in 2015-2019, 258 men per 100,000 in Georgia diagnosed with cancer

The first place in terms of cancer locations is lung cancer (AAR=38.8), II - prostate (AAR=30.9), III
- bladder (ASR=23.3), IV - skin (AAR=23.2), V - colorectal cancer (AAR=23.1).

In 2015-2019, the cumulative risk of cancer in men under 65 years of age in Georgia was 10.5, which almost doubles to 20.0 by age 75.

Conclusions: It was determined that the laws of Georgia (2002) recognize the necessity of access to opioids for medical purposes, while the by-laws (2008) restrict it and allow it - for incurable patients, in the terminal phase of the disease (2018). Over the past 6 months;
Therefore, pain management is adjusted not to medical indications, but to the diagnosis, prognosis and expected period of life.

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Presenting Author: Natia Shavdia
Submitting Author: Natia Shavdia

Senior Author: Mikheil Shavdia

IASP 2026 Global Year theme of Neuropathic Pain: No