Higher opioid prescription rates persist among survivors of cancer even 10-years post-diagnosis without recurrence, according to a study published in Cancer.1

Chronic pain is a serious effect of disease burden and treatment among patients with cancer, and can persist for years after the disease is cured. Whether opioids are overprescribed among survivors is, however, unknown.

For this population-matched cohort study, researchers enrolled 17,202 individuals, half of whom were cancer survivors and half of whom were healthy controls, to compare opioid prescription rates between the 2 groups.

All survivors were diagnosed at least 5 years before this study with no evidence of recurrence; the median time since diagnosis was 10 years (range, 7 to 16). Survivors were matched based on gender and age, though other variables, including socioeconomic status and comorbidities, were accounted for only after multivariable adjustment.

The adjusted relative rate (RR) of opioid prescribing among survivors was 1.219. Prescription rates were consistently higher among poorer survivors: those in the lowest income quintile had an RR of opioid prescriptions of 1.937 vs the highest quintile.

Survivors of lung, gastrointestinal, genitourinary, or gynecologic cancers all had higher opioid prescription rates than health controls. Survivors of breast cancer, however, had similar prescription rates to controls.

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The authors concluded that physicians “providing primary care to cancer survivors should consider close examination of reasons for continued opioid use in order to differentiate chronic pain from dependency, as well as explore alternative methods for pain control, such as physical therapy, exercise, and acupuncture.”

Reference

  1. Sutradhar R, Lokku A, Barbera L. Cancer survivorship and opioid prescribing rates: a population-based matched cohort study among individuals with and without a history of cancer. Cancer. 2017 Apr 7. doi: 10.1002/cncr.30839 [Epub ahead of print]