ArticleJournal of the National Cancer Institute2026
Opioid use after breast cancer in Denmark: a nationwide study of social and clinical factors.
Article in Journal of the National Cancer Institute, 2026. 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
backgroundPain is a common, long-lasting effect of breast cancer treatment, but adequate pain management can be a challenge in survivorship care. Opioids remain important for acute and chronic pain, yet prolonged use carries risks of dependence and overdose. Denmark has historically had high opioid prescription rates, but the duration, strength, and intensity of use among breast cancer survivors is not well described.
methodsWe conducted a nationwide registry-based study of 84 610 Danish women diagnosed with stage I to III breast cancer between 1997 and 2020. We described temporal trends in opioid prescribing and examined associations between sociodemographic and clinical characteristics and 5 potentially harmful opioid-related outcomes after breast cancer: new and prolonged use, long-term use, long-term strong use, concurrent use with sedative hypnotics, and diagnosed substance-related disorder or overdose.
resultsWithin 1 year of diagnosis, 18% of women filled at least 1 opioid prescription; this proportion declined steadily after 2015. Codeine, the most common initial opioid in the late 1990s, was gradually replaced by tramadol, morphine, and oxycodone. Across the cohort, 6.1% had long-term use, 2.0% had long-term strong use, 3.6% had concurrent opioid and sedative hypnotic use, and 0.4% developed a substance-related disorder or overdose. Among 74 771 opioid-naïve patients, 1.7% became new and prolonged users. The odds of these opioid-related behaviors were higher among women with socioeconomic hardships, psychiatric morbidity, comorbidity, and advanced disease.
conclusionOpioid use after breast cancer was uncommon and declined over time in Denmark. Nonetheless, social and clinical disparities persisted, highlighting the importance of survivorship care that balances safe prescribing with adequate pain management.
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