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Opioid Use Disorder and Overdose in Older Adults With Breast, Colorectal, or Prostate Cancer.

Publication ,  Journal Article
Roberts, AW; Eiffert, S; Wulff-Burchfield, EM; Dusetzina, SB; Check, DK
Published in: J Natl Cancer Inst
April 6, 2021

BACKGROUND: Despite high rates of opioid therapy, evidence about the risk of preventable opioid harms among cancer survivors is underdeveloped. Our objective was to estimate the odds of opioid use disorder (OUD) and overdose following breast, colorectal, or prostate cancer diagnosis among Medicare beneficiaries. METHODS: We conducted a retrospective cohort study using 2007-2014 Surveillance, Epidemiology, and End Results-Medicare data for cancer survivors with a first cancer diagnosis of stage 0-III breast, colorectal, or prostate cancer at age 66-89 years between 2008 and 2013. Cancer survivors were matched to up to 2 noncancer controls on age, sex, and Surveillance, Epidemiology, and End Results region. Using Firth logistic regression, we estimated adjusted 1-year odds of OUD or nonfatal opioid overdose associated with a cancer diagnosis. We also estimated adjusted odds of OUD and overdose separately and by cancer stage, prior opioid use, and follow-up time. RESULTS: Among 69 889 cancer survivors and 125 007 controls, the unadjusted rates of OUD or nonfatal overdose were 25.2, 27.1, 38.9, and 12.4 events per 10 000 patients in the noncancer, breast, colorectal, and prostate samples, respectively. There was no association between cancer and OUD. Colorectal survivors had 2.3 times higher odds of opioid overdose compared with matched controls (adjusted odds ratio = 2.33, 95% confidence interval  = 1.49 to 3.67). Additionally, overdose risk was greater in those with more advanced disease, no prior opioid use, and preexisting mental health conditions. CONCLUSIONS: Opioid overdose was a rare, but statistically significant, outcome following stage II-III colorectal cancer diagnosis, particularly among previously opioid-naïve patients. These patients may require heightened screening and intervention to prevent inadvertent adverse opioid harms.

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Published In

J Natl Cancer Inst

DOI

EISSN

1460-2105

Publication Date

April 6, 2021

Volume

113

Issue

4

Start / End Page

425 / 433

Location

United States

Related Subject Headings

  • United States
  • SEER Program
  • Retrospective Studies
  • Prostatic Neoplasms
  • Opioid-Related Disorders
  • Opiate Overdose
  • Oncology & Carcinogenesis
  • Odds Ratio
  • Medicare
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Roberts, A. W., Eiffert, S., Wulff-Burchfield, E. M., Dusetzina, S. B., & Check, D. K. (2021). Opioid Use Disorder and Overdose in Older Adults With Breast, Colorectal, or Prostate Cancer. J Natl Cancer Inst, 113(4), 425–433. https://doi.org/10.1093/jnci/djaa122
Roberts, Andrew W., Samantha Eiffert, Elizabeth M. Wulff-Burchfield, Stacie B. Dusetzina, and Devon K. Check. “Opioid Use Disorder and Overdose in Older Adults With Breast, Colorectal, or Prostate Cancer.J Natl Cancer Inst 113, no. 4 (April 6, 2021): 425–33. https://doi.org/10.1093/jnci/djaa122.
Roberts AW, Eiffert S, Wulff-Burchfield EM, Dusetzina SB, Check DK. Opioid Use Disorder and Overdose in Older Adults With Breast, Colorectal, or Prostate Cancer. J Natl Cancer Inst. 2021 Apr 6;113(4):425–33.
Roberts, Andrew W., et al. “Opioid Use Disorder and Overdose in Older Adults With Breast, Colorectal, or Prostate Cancer.J Natl Cancer Inst, vol. 113, no. 4, Apr. 2021, pp. 425–33. Pubmed, doi:10.1093/jnci/djaa122.
Roberts AW, Eiffert S, Wulff-Burchfield EM, Dusetzina SB, Check DK. Opioid Use Disorder and Overdose in Older Adults With Breast, Colorectal, or Prostate Cancer. J Natl Cancer Inst. 2021 Apr 6;113(4):425–433.
Journal cover image

Published In

J Natl Cancer Inst

DOI

EISSN

1460-2105

Publication Date

April 6, 2021

Volume

113

Issue

4

Start / End Page

425 / 433

Location

United States

Related Subject Headings

  • United States
  • SEER Program
  • Retrospective Studies
  • Prostatic Neoplasms
  • Opioid-Related Disorders
  • Opiate Overdose
  • Oncology & Carcinogenesis
  • Odds Ratio
  • Medicare
  • Male