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Chronic opioid use and incident opioid use disorders in survivors of adolescent and young adult cancer after cancer

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Adolescent and young adult cancer survivors face higher risks of long-term opioid use and related complications compared to their non-cancer peers. Understanding these risks is crucial for better patient monitoring and care strategies.

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Area of Science:

  • Oncology
  • Pain Management
  • Public Health

Background:

  • Opioid use, benefits, and harms are not well understood in cancer survivors.
  • Adolescent and Young Adult (AYA) cancer survivors' opioid use and outcomes post-treatment require examination.

Purpose of the Study:

  • To investigate long-term opioid use and associated outcomes in AYA cancer survivors.
  • To compare opioid-related risks between AYA cancer survivors and individuals without cancer.

Main Methods:

  • Identified 2-year AYA cancer survivors (15-39 years) and matched non-cancer controls.
  • Utilized Poisson and Fine-Gray hazard models to compare long-term opioid use, high-dose use, benzodiazepine co-use, opioid use disorder (OUD), overdose, and hospitalization.
  • Analyzed risk factors for opioid-related outcomes within the cancer survivor group.

Main Results:

  • AYA cancer survivors showed significantly higher long-term opioid use (5.2% vs 1.8%).
  • Cancer survivors had increased incidence of long-term high-dose opioid use, benzodiazepine co-use, and opioid-related hospitalizations.
  • Among those on long-term opioid therapy, survivors had higher risks for high-dose use and co-use but lower OUD risk; early opioid use predicted later OUD/overdose.

Conclusions:

  • Findings highlight the need for risk-stratified monitoring of AYA cancer survivors regarding opioid use.
  • Further research is needed to understand the nuanced OUD risk profile in this population.