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Cancer Causes Control. 2019 Dec;30(12):1341-1350. doi: 10.1007/s10552-019-01236-5. Epub 2019 Oct 30.

Changes in use of opioid therapy after colon cancer diagnosis: a population-based study.

Author information

1
Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA. lu.chen@kp.org.
2
Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA.
3
Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
4
Kaiser Permanente Colorado Institute for Health Research, Denver, CO, USA.
5
Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
6
Department of Pharmacy, University of Washington, Seattle, WA, USA.

Abstract

PURPOSE:

To describe patterns of opioid use in cancer survivors.

METHODS:

In a cohort study of colon cancer patients diagnosed during 1995-2014 and enrolled at two Kaiser Permanente regions, we constructed quarterly measures of opioid use from 1 year before cancer diagnosis through 5 years after diagnosis to examine changes in use. Measures included any use, incident use, regular use (use ≥ 45 days in a 91-day quarter), and average daily dose (converted to morphine milligram equivalent, MME). We also assessed temporal trends of opioid use.

RESULTS:

Of 2,039 colon cancer patients, 11-15% received opioids in the four pre-diagnosis quarters, 68% in the first quarter after diagnosis, and 15-17% in each subsequent 19 quarters. Regular opioid use increased from 3 to 5% pre-diagnosis to 5-7% post diagnosis. Average dose increased from 15 to 17 MME/day pre-diagnosis to 14-22 MME/day post diagnosis (excluding the quarter in which cancer was diagnosed). Among post-diagnosis opioid users, 73-95% were on a low dose (< 20 MME/day). Over years, regular use of opioids increased in survivorship with no change in dosage.

CONCLUSION:

Opioid use slightly increased following a colon cancer diagnosis, but high-dose use was rare. Research is needed to differentiate under- versus over-treatment of cancer pain.

KEYWORDS:

Cancer pain; Colon cancer; Opioid therapy; Survivorship

PMID:
31667710
PMCID:
PMC6863090
[Available on 2020-12-01]
DOI:
10.1007/s10552-019-01236-5

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