Cancer survivors: chronic opioid use more common in first few years

  • Salz T & al.
  • J Clin Oncol
  • 28 Feb 2019

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Older, opioid-naive patients with colorectal and lung cancer initially have higher rates of chronic opioid use than older people without cancer, but the gap narrows over time and is absent by 6 years postdiagnosis.
  • Chronic opioid use was less likely among breast cancer survivors than matched control patients without cancer.

Why this matters

  • Chronic opioid use among matched control patients increased from the first to the last year of the study period.

Study design

  • 46,789 opioid-naive survivors of colorectal, lung, and breast cancers diagnosed between 2008 and 2013 and 138,136 noncancer control patients were evaluated.
  • Chronic opioid use defined as ≥90 days of consecutive use.
  • Funding: NIH.

Key results

  • Chronic use among colorectal (OR, 1.34; 95% CI, 1.22-1.47), lung (OR, 2.55; 95% CI, 2.34-2.77) cancer survivors exceeded that of control patients in the first follow-up year.
  • Colorectal cancer survivors with chronic opioid use were more likely vs control patients to have high-dose opioid use in the first 3 years of follow-up (ORs, from 1.79 to 2.61; all P<.05>
  • Lung cancer survivors with chronic opioid use were more likely vs control patients to have high-dose opioid use for first the 4 years of follow-up (ORs, from 3.65 to 5.54; all P<.05>
  • Chronic opioid use was less likely in breast cancer survivors.

Limitations

  • Patients with progressive/recurrent disease were included.

Coauthored with Antara Ghosh, PhD

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