ArticleJournal of cancer survivorship : research and practice2025
Opioid prescribing to older cancer survivors: a retrospective claims-based characterization of prescriber specialties.
Article in Journal of cancer survivorship : research and practice, 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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8 authors.
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Abstract
purposeOlder cancer survivors have concerning rates of unsafe opioid prescribing. Little is known about the specialty of providers prescribing to survivors, which is essential to guide interventions.
methodsUsing SEER-Medicare data, we identified adults age > 65 diagnosed 2014-2017 with stage I-III female breast, lung, or colorectal cancer with ≥6 months treatment-free follow-up through 2019. Each opioid filled after treatment completion was assigned to a prescriber specialty: oncology, surgery, primary care, pain medicine, or other. Generalized estimating equation models captured the relative likelihood of an opioid being prescribed by each provider specialty.
resultsAmong 69,769 survivors, 46% of breast, 49% of colorectal, and 49% of lung cancer survivors filled ≥1 opioid prescription during follow-up. For all three cancers, primary care providers (PCPs) prescribed a greater share of opioid fills (50%-56%) than other specialists, prescribed opioids to a greater share of survivors (49%-56%) than other specialists, and prescribed opioids for longer durations (median 30 days/year) than oncologists and surgeons. The likelihood of an opioid being prescribed by an oncologist was up to 9 times lower than that of it being prescribed by a PCP: probability ratios 0.11 (95% CI 0.10-0.13) for breast, 0.12 (95% CI, 0.10-0.14) for colorectal, and 0.15 (95% CI, 0.13-0.17) for lung cancer survivors.
conclusionPCPs are highly involved in prescribing opioids to older survivors of common cancers. Interventions to enhance pain management for survivors should target primary care. IMPLICATIONS FOR CANCER SURVIVORS: As survivors transition away from oncology-based care, oncologists must communicate with PCPs about ongoing pain and opioid prescribing.
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