{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T03:32:06Z","timestamp":1784691126283,"version":"3.55.0"},"reference-count":37,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2014,2,1]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> To understand changes in pain severity over time and to explore the factors associated with pain changes in ambulatory patients with solid tumors. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> We enrolled 3,106 patients with invasive cancer of the breast, prostate, colon\/rectum, or lung from multiple sites. At baseline and 4 to 5 weeks later, patients rated their pain level on a 0 to 10 numerical rating scale. A 2-point change in pain score was defined as a clinically significant change in pain. Multivariable logistic models were fitted to examine the effects of pain management and demographic and clinical factors on change in pain severity. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> We analyzed 2,761 patients for changes in pain severity. At initial assessment, 53.0% had no pain, 23.5% had mild pain, 10.3% had moderate pain, and 13.2% had severe pain. Overall, one third of patients with initial pain had pain reduction within 1 month of follow-up, and one fifth had an increase, and the improvement and worsening of pain varied by baseline pain score. Of the patients without pain at initial assessment, 28.4% had pain (8.9% moderate to severe) at the follow-up assessment. Logistic regression analysis showed that inadequate pain management was significantly associated with pain deterioration, as were lower baseline pain level, younger age, and poor health status. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> One third of patients have pain improvement and one fifth experience pain deterioration within 1 month after initial assessment. Inadequate pain management, baseline pain severity, and certain patient demographic and disease characteristics are associated with pain deterioration. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2013.50.6071","type":"journal-article","created":{"date-parts":[[2013,12,24]],"date-time":"2013-12-24T04:29:08Z","timestamp":1387859348000},"page":"312-319","source":"Crossref","is-referenced-by-count":31,"title":["Determinants of Pain Severity Changes in Ambulatory Patients With Cancer: An Analysis From Eastern Cooperative Oncology Group Trial E2Z02"],"prefix":"10.1200","volume":"32","author":[{"given":"Fengmin","family":"Zhao","sequence":"first","affiliation":[{"name":"Fengmin Zhao, Dana-Farber Cancer Institute, Boston, MA; Victor T. Chang, Veterans' Affairs New Jersey Health Care System\/Rutgers\u2013New Jersey Medical School, East Orange, NJ; Charles Cleeland and Michael J. Fisch, The University of Texas MD Anderson Cancer Center, Houston, TX; James F. Cleary, University of Wisconsin, Madison, WI; Edith P. Mitchell, Thomas Jefferson University, Philadelphia, PA; and Lynne I. Wagner, Northwestern University Feinberg School of Medicine, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor T.","family":"Chang","sequence":"additional","affiliation":[{"name":"Fengmin Zhao, Dana-Farber Cancer Institute, Boston, MA; Victor T. Chang, Veterans' Affairs New Jersey Health Care System\/Rutgers\u2013New Jersey Medical School, East Orange, NJ; Charles Cleeland and Michael J. Fisch, The University of Texas MD Anderson Cancer Center, Houston, TX; James F. Cleary, University of Wisconsin, Madison, WI; Edith P. Mitchell, Thomas Jefferson University, Philadelphia, PA; and Lynne I. 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Chang, Veterans' Affairs New Jersey Health Care System\/Rutgers\u2013New Jersey Medical School, East Orange, NJ; Charles Cleeland and Michael J. Fisch, The University of Texas MD Anderson Cancer Center, Houston, TX; James F. Cleary, University of Wisconsin, Madison, WI; Edith P. Mitchell, Thomas Jefferson University, Philadelphia, PA; and Lynne I. Wagner, Northwestern University Feinberg School of Medicine, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith P.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Fengmin Zhao, Dana-Farber Cancer Institute, Boston, MA; Victor T. Chang, Veterans' Affairs New Jersey Health Care System\/Rutgers\u2013New Jersey Medical School, East Orange, NJ; Charles Cleeland and Michael J. Fisch, The University of Texas MD Anderson Cancer Center, Houston, TX; James F. Cleary, University of Wisconsin, Madison, WI; Edith P. Mitchell, Thomas Jefferson University, Philadelphia, PA; and Lynne I. 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