Opioid Use in Patients With Cervical Cancer at Two Urban Medical Centers

Area of Science:

• Oncology
• Pain Management
• Public Health

Background:

• Cervical cancer patients face a high risk of opioid dependence.
• Understanding opioid prescribing patterns is crucial for managing pain and preventing misuse.

Purpose of the Study:

• To characterize outpatient opioid prescribing patterns in cervical cancer patients at two urban hospitals.
• To identify factors associated with long-term opioid use in this population.

Main Methods:

• Retrospective data collection from 2011-2018 for cervical cancer patients treated with curative intent.
• Exclusion criteria included pre-existing chronic opioid use, persistent disease at 3 months, or opioid initiation >6 months post-treatment.
• Data collected on demographics, disease characteristics, treatment, and outpatient opioid prescriptions; duration of use (≥6 and ≥12 months) was analyzed.

Main Results:

• 106 women were included; 85.8% received outpatient opioids.
• Opioid prescriptions were most common before therapy (35.9%), post-procedure (26.4%), and during radiation (17.0%).
• Median opioid use duration was 3 months, with 35.2% using ≥6 months and 22% using ≥12 months. Advanced FIGO stage, recurrent disease, pre-treatment opioid initiation, and co-medications (gabapentin, steroids) were linked to long-term use.

Conclusions:

• A majority of cervical cancer patients receive outpatient opioids, with a significant proportion experiencing long-term use.
• Interventions focusing on provider communication, education, post-treatment monitoring, and non-opioid therapies are necessary.
• Reducing long-term opioid use requires a multi-faceted approach in cervical cancer care.