ArticleJNCI cancer spectrum2025
Persistent prescription opioid use and all-cause mortality following the first-year breast cancer survivorship.
Article in JNCI cancer spectrum, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHarm associated with persistent opioid use beyond the first-year intensive cancer treatment is underinvestigated in cancer survivors. We examined rates and risk factors for persistent opioid use and all-cause mortality after the first-year breast cancer survivorship.
methodsThis retrospective cohort study used electronic health record data from Kaiser Permanente Southern California for women diagnosed with a nonmetastatic breast cancer between 2009 and 2019 who filled 2 or more opioid prescriptions. Rates of persistent opioid use were estimated from first-year survivorship through December 31, 2021. Rate ratios (RRs) and 95% confidence intervals (CIs) for factors associated with persistent use were estimated using a multivariable Poisson regression model. Hazard ratios (HRs) for all-cause mortality associated with persistent opioid use were estimated using multivariable Cox regression models.
resultsOf 14 347 eligible individuals (mean [SD] age = 61.9 [12.5]), 2285 (15.9%) developed persistent opioid use, with an incident rate of 25.5 per 1000 person-years. Risk factors included older age (≥65 vs < 65 years: RR = 1.63, 95% CI = 1.24 to 2.14), smoking (current: 1.89, 1.68 to 2.13; former: 1.30, 1.20 to 1.41), baseline comorbidities (Elixhauser Comorbidity Index 5+ vs 0: 1.70, 1.29 to 2.24), and substance use disorders (1.58, 1.43 to 1.74). All-cause mortality was doubled among individuals with persistent use (51.6, 48.0 to 55.6 per 1000 person-years) than in those without (25.3, 24.2 to 26.4). Persistent use was associated with an increased all-cause mortality (adjusted HR = 1.84, 1.66 to 2.04).
conclusionsPersistent opioid use was common in breast cancer survivors and associated with increased mortality. Further research is needed to explore factors that may be contributing to increased mortality.
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