The association of prescription opioid use with incident cancer: A Surveillance, Epidemiology, and End Results‐Medicare population‐based case‐control study

Abstract

BACKGROUND: Cancer is the second leading cause of death globally, and researchers seek to identify modifiable risk factors Over the past several decades, there has been ongoing debate whether opioids are associated with cancer development, metastasis, or recurrence. Basic science, clinical, and observational studies have produced conflicting results. The authors examined the association between prescription opioids and incident cancers using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. A complex relation was observed between prescription opioids and incident cancer, and cancer site may be an important determinant. METHODS: By using linked SEER cancer registry and Medicare claims from 2008 through 2013, a case-control study was conducted examining the relation between cancer onset and prior opioid exposure. Logistic regression was used to account for differences between cases and controls for 10 cancer sites. RESULTS: Of the population studied (n = 348,319), 34% were prescribed opioids, 79.5% were white, 36.9% were dually eligible (for both Medicare and Medicaid), 13% lived in a rural area, 52.7% had ≥1 comorbidity, and 16% had a smoking-related diagnosis. Patients exposed to opioids had a lower odds ratio (OR) associated with breast cancer (adjusted OR, 0.96; 95% CI, 0.92-0.99) and colon cancer (adjusted OR, 0.90; 95% CI, 0.86-0.93) compared with controls. Higher ORs for kidney cancer, leukemia, liver cancer, lung cancer, and lymphoma, ranging from lung cancer (OR, 1.04; 95% CI, 1.01-1.07) to liver cancer (OR, 1.19; 95% CI, 1.08-1.31), were present in the exposed population. CONCLUSIONS: The current results suggest that an association exists between prescription opioids and incident cancer and that cancer site may play an important role. These findings can direct future research on specific patient populations that may benefit or be harmed by prescription opioid exposure.

Intraoperative low-dose dopamine is associated with worse survival in patients with hepatocellular carcinoma: A propensity score matching analysis

“…This retrospective study has several limitations. First, we do not have information on the other factors that could affect cancer recurrence, such as perioperative opioid consumption and postoperative complications ( 33 – 35 ). Second, the time interval from hepatectomy to recurrence is an important prognostic factor and somewhat controversial, ranging from 6 months to 2 years after surgery ( 36 , 37 ).…”

Opioids and Cancer: Current Understanding and Clinical Considerations

“…The results of a multivariate analysis indicated that patients in the opioid group had a higher risk of developing cancer with an aHR of 2.66 (95% CI: 1. 44 [91]. The study population (N = 348,319) included 143,921 cancer patients who were matched with 204,398 controls, of whom, 34% were prescribed with opioids.…”

“…Another case–control study by Havidich et al utilized the SEER tumor registry and linked it with Medicare’s prescriptions data [ 91 ]. The study population (N = 348,319) included 143,921 cancer patients who were matched with 204,398 controls, of whom, 34% were prescribed with opioids.…”