Georgia showed the largest improvement in the United States in a national study evaluating state policies to improve pain management and patient care, with its "grade" jumping from a D+ to a B, the American Cancer Society reported Tuesday.

Researchers analyzed whether state pain policies and regulations enhanced or impeded pain management. The study, by the University of Wisconsin's Pain & Policy Studies Group, said only five states received a grade of "A" for enabling health care professionals to effectively alleviate the suffering of their patients, without encountering barriers in legislation or regulation.

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Each state was assigned a grade from "A" to "F" — reflecting the quality of its pain policies. The study also evaluated pain policies in 2000, 2003, 2006 and 2007 to determine what changes had been made over time.

The study authors said this year's report showed increased momentum for "positive policy change" over the last year.

Georgia, Maine, Minnesota, Oregon, Rhode Island, Utah and Washington had policy changes sufficient to improve their grades. The report did not outline what those policy changes were, and state officials could not be reached immediately for comment.

According to the study, Oregon received an A, along with Kansas, Michigan, Virginia and Wisconsin.

The report, "Achieving Balance in State Pain Policy A Progress Report Card," was funded by the American Cancer Society, the Lance Armstrong Foundation and Susan G. Komen for the Cure.

The study said:

• 45 states now have a grade above C.

• The five states achieving an A comprised 10 percent of the total U.S. population. States with grades of B or B+ made up about 50 percent of the U.S. population. Another 39 percent of the population lives in the 18 states that had a grade of C or C+.

• No state's grade decreased.

"A growing number of state health care regulatory agencies have recognized the importance of adopting policies that encourage pain management, palliative care and end-of-life care," said Aaron Gilson, director of the PPSG program. "However, states need to continue to eliminate restrictive or ambiguous legislative language in order to improve pain management for patients with cancer, HIV/AIDS and other diseases."

John Seffrin, chief executive officer of the American Cancer Society, said the research showed "a very encouraging improvement in state pain policies, but more needs to be done to effectively address the national health crisis of undertreated pain."

He said states need to inform the medical community about pain policies so that more people in pain can benefit.

"Patients, health organizations, health care professionals, regulatory officials, licensing boards and policymakers all have a role to play to promote a balanced approach to pain control policy and practice," Seffrin said.

Doug Ulman, president of the Lance Armstrong Foundation, said cancer survivors "deserve to have their pain managed effectively so that they can focus on living well on their own. We know that many states still have work to do to improve barriers to effective pain management, and we are proud to join in that critical work."