Cancer pain care access remains unequal for some patients, according to a new analysis of real-world treatment records that found racial and ethnic differences in how quickly patients with cancer receive pain medication and how often they are prescribed strong opioids. A new analysis of real-world treatment records has found racial and ethnic differences in how quickly some patients with cancer receive pain medication, adding to ongoing concerns about equity in cancer-related pain care.

The study, presented at the 2026 American Society of Clinical Oncology Annual Meeting, reviewed electronic health records from The US Oncology Network for more than 100,000 patients with breast, prostate and pancreatic cancer who were treated in community oncology settings between January 2021 and June 2025.

Researchers found that some Black and Asian patients experienced longer waits for pain medication and, in certain cancer groups, received strong opioid prescriptions at lower rates than white patients. The findings do not suggest that patients from different racial or ethnic backgrounds experience pain differently. Instead, they point to possible differences in how pain is assessed, documented and treated across health care settings.

Among breast cancer patients, the median time to a first pain prescription was 65 days for white patients and 80 days for Black patients. Asian patients with breast cancer received strong opioid prescriptions at a rate of 28 percent, compared with 32 percent for Black patients and 35 percent for white patients.

The pattern was especially noticeable among prostate cancer patients. Asian patients waited a median of 86 days for pain medication, compared with 50 days for white patients. They were also prescribed strong opioids at a lower rate, 28 percent, compared with 54 percent among Black patients and 50 percent among white patients.

The differences were smaller among patients with pancreatic cancer, where care often moves more quickly because the disease is commonly diagnosed at a later stage. Still, the study found that 58 percent of Black patients with pancreatic cancer received strong opioids, compared with 64 percent of white patients.

Ila Sruti, MPH, an outcomes researcher at Ontada and the study’s lead author, told the American Journal of Managed Care that the findings highlight the need for more consistent pain management protocols across community oncology practices. Standardized, guideline-based approaches may help reduce variation in care and ensure that patients receive timely pain relief based on clinical need.

The research adds to a larger body of evidence showing that patients from racially and ethnically underserved communities may face barriers to adequate pain treatment, even when factors such as insurance status, income and disease severity are taken into account.

The Centers for Disease Control and Prevention has previously reported disparities in access to pain care, including differences in access to analgesia for acute pain, opioid dosage and referrals to pain specialists. A related study published this year in Cancer Medicine, which examined more than 300,000 older cancer survivors, also found that Black, Asian and Pacific Islander, and other minority patients had less access to pain treatment overall than white patients.

Why timely pain care matters

Cancer pain is more than a quality-of-life issue. When pain is not properly managed, patients may experience greater distress, reduced mobility, difficulty sleeping and more frequent use of emergency or hospital care. Clinical guidance from the American Society of Clinical Oncology notes that pain affects many people with cancer and can become more severe as disease progresses.

Other research has also linked differences in pain treatment to broader health care inequities near the end of life. A study published in the British Journal of Cancer found that Black and South Asian patients in the last three months of life were prescribed opioids at lower rates than white patients and were more likely to have multiple emergency department visits and hospital admissions.

For researchers, clinicians and patient advocates, the new ASCO findings reinforce an important point: access to cancer treatment is only one part of equitable care. Patients also need timely relief from pain, clear communication with their care teams and treatment decisions guided by consistent standards rather than uneven practice patterns.

Experts involved in this area of research have pointed to several possible steps, including standardized pain assessment tools, protocol-driven prescribing practices, clinician training on bias and regular review of prescribing patterns by race and ethnicity within health systems.

As real-world health data becomes more widely used in research, studies like this can help identify gaps that patients and clinicians have described for years. The next challenge is turning that evidence into practical changes in the community oncology clinics where many Americans receive cancer care.

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