Evidence map›Paper›PMID 40916563›Full record

Observational studyCancer2025

The impact of opioid use associated with curative-intent cancer surgery on safe opioid prescribing practice among veterans: An observational study.

Marilyn M Schapira, Sumedha Chhatre, Patience M Dow, Charles E Leonard, Peter Groeneveld, Jason M Prigge, Christopher Roberts, Zachary F Meisel, Ravi B Parikh, Ravishankar Jayadevappa and 6 more

Abstract readObservational Study
In one paragraph

Observational study in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Marilyn M SchapiraCenter for Healthcare Evaluation, Research, and Promotion, Corporal Michael J. Crescenz Veterans Affairs (VA) Medical Center, Philadelphia, Pennsylvania, USA.
Sumedha ChhatreCenter for Healthcare Evaluation, Research, and Promotion, Corporal Michael J. Crescenz Veterans Affairs (VA) Medical Center, Philadelphia, Pennsylvania, USA.
Patience M DowDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Charles E LeonardDepartment of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Peter GroeneveldCenter for Healthcare Evaluation, Research, and Promotion, Corporal Michael J. Crescenz Veterans Affairs (VA) Medical Center, Philadelphia, Pennsylvania, USA.
Jason M PriggeCenter for Healthcare Evaluation, Research, and Promotion, Corporal Michael J. Crescenz Veterans Affairs (VA) Medical Center, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0003-2217-9737
Christopher RobertsCenter for Healthcare Evaluation, Research, and Promotion, Corporal Michael J. Crescenz Veterans Affairs (VA) Medical Center, Philadelphia, Pennsylvania, USA.
Zachary F MeiselThe Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Ravi B ParikhDepartment of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.
Ravishankar JayadevappaCenter for Healthcare Evaluation, Research, and Promotion, Corporal Michael J. Crescenz Veterans Affairs (VA) Medical Center, Philadelphia, Pennsylvania, USA.
Emily C PaulsonDepartment of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Robert S KrouseDepartment of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-7176-461X
Katie J SudaCenter for Healthcare Evaluation, Research, and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Pallavi KumarDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Visala MulukVA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Rebecca A HubbardDepartment of Biostatistics, Brown University School of Public Health, Providence, Rhode Island, USA.ORCID https://orcid.org/0000-0003-0879-0994

Funding

US Department of Veterans Affairs 1121HX003273-0
6 · The paper itself

Abstract

backgroundOpioid exposure during cancer therapy may increase long-term unsafe opioid prescribing. This study sought to determine the rates of coprescription of benzodiazepine and opioid medications and new persistent opioid use after surgical treatment of early-stage cancer.

methodsA retrospective cohort study was conducted among a US veteran population via the Veterans Affairs Corporate Data Warehouse database. Participants were opioid-naive persons aged ≥21 years with a new diagnosis of stage 0-III cancer between January 1, 2015, and December 31, 2016. Outcomes were days of coprescription of benzodiazepines and opioids in the 13 months posttreatment and new persistent opioid use. The exposure was total morphine milligram equivalents (MMEs) attributed to treatment and prescribed from 30 days before through 14 days after the index surgical procedure.

resultsAmong 9213 veterans, coprescription of benzodiazepines and opioids occurred in 366 patients (4.0%) and new persistent opioid use in 981 patients (10.6%). In a linear model adjusting for patient, clinical, and geographic factors, persons in the highest quartile compared to no opioid exposure had increased days with coprescription of benzodiazepines and opioids (mean difference, 1.0; 95% CI, 0.3-1.7). In a discrete time survival analysis, persons in the highest quartile of MME exposure compared to none had a greater risk of new persistent opioid use (hazard ratio, 1.6; 95% CI, 1.3-1.9).

conclusionsMore than one of 10 opioid-naive veterans undergoing curative-intent surgical treatment for cancer developed new persistent opioid use. Optimizing cancer treatment pain management strategies to mitigate long-term opioid-related health risks is crucial.

Indexed as

Analgesics, OpioidCancer PainNeoplasmsPostoperative PainPractice Patterns, Physicians'AdultAgedBenzodiazepinesDrug PrescriptionsFemaleHumansMaleMiddle AgedRetrospective StudiesUnited StatesVeteransAnalgesics, OpioidBenzodiazepinescancer survivorshipcurative‐intent surgical cancer treatmentearly‐stage cancernew persistent opioid use

Identifiers

PMID40916563
PMCPMC12415502

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.