Assessment of cancer pain management knowledge in southwest China: a survey of 259 physicians from small city and county hospitals. 
Pain management is a critical issue in the care of cancer patients in China, especially in small city and county hospitals in southwest China.  The study intended to determine Chinese physicians' competence in cancer pain management and to assess their opinions on barriers to optimal pain management.  A questionnaire on pain management was given to 259 fellows after their general orientation meeting at a tertiary teaching hospital.  The questionnaire was adapted from an earlier study by the Eastern Cooperative Oncology Group (ECOG).  The majority of the fellows believed that 70% of cancer patients suffer pain.  Nearly 90% (224/259) indicated that their training in cancer pain management was poor.  The fellows stated that concern about morphine addiction was the primary reason they hesitated to prescribe opioids, and they identified inadequate assessment of cancer pain as the most significant barrier to optimal management of cancer pain.  The study reflects to some extent the state of pain management in hospitals in southwest China.  Medical students and physicians in China need improved pain management education.