ArticleJournal of the National Cancer Institute2026
Racial and ethnic differences in opioid fills following cancer-directed surgery among older and younger Medicare beneficiaries.
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
backgroundOpioid receipt differs by race and ethnicity across multiple settings, yet few studies have examined disparities after cancer-directed surgery.
methodsUsing fee-for-service Medicare claims, we identified cancer-directed surgeries between 2012 to 2021. Multivariable linear regression models estimated racial and ethnic differences in postoperative opioid fills and doses within 30-days, adjusting for demographic and clinical factors. We ran separate models among older (age ≥ 65) and younger (age < 65) Medicare beneficiaries (who typically qualify based on disability), and further models by preoperative opioid use (opioid-naïve vs not).
resultsWe identified 958,593 surgical episodes. Overall 84.9% were non-Hispanic White (White), 8.1% non-Hispanic Black (Black), 4.4% Hispanic, and 2.2% Asian. Among older beneficiaries, Black and Hispanic patients were 4.7 [95%CI : 4.3,5.1] and 3.1 [95%CI : 2.6,3.6] percentage points more likely to fill ≥1 opioid than White patients. Mean 30day doses were similar between Black and White patients; whereas Hispanic and Asian patients filled modestly lower doses (-22 MME [95%CI:-27,-16], -53 MME [95%CI:-61,-46]). Among younger beneficiaries, opioid fill rates were relatively similar across racial and ethnic groups. However, mean 30-day doses were substantially lower among Black (-135 MME [95%CI:-154,-115]), Hispanic (-167 MME [95%CI:-198,-136]), and Asian (-259 MME [95%CI:-327,-191]) vs White patients, particularly those with prior opioid use.
conclusionsWe observed modest racial and ethnic differences in opioid fills following cancer-directed surgeries among older Medicare beneficiaries. However, among younger beneficiaries, Black, Hispanic, and Asian patients filled substantially lower 30-day doses than White patients, primarily among those with prior opioid use. Cancer pain equity efforts should target populations experiencing meaningful disparities.
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