Xu Ji1,2, Xin Hu3, Katharine E Brock1,2, Ann C Mertens4,5,6, Janet R Cummings3, Karen E Effinger7,8. 1. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA. 2. Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA. 3. Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, GA, USA. 4. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA. 5. Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA. 6. Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA. 7. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA. 8. Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Abstract
BACKGROUND: Pediatric cancer survivors often have pain, which may be managed with opioids. We examined the prevalence of opioid prescriptions, potential misuse, and substance use disorders (SUDs) among pediatric cancer survivors during the first year posttherapy. METHODS: Using MarketScan Commercial Database, we identified 8969 survivors (aged 21 years or younger at diagnosis) who completed cancer therapy in 2009-2018 and remained continuously enrolled for at least 1 year posttherapy and 44 845 age-, sex-, and region-matched enrollees without cancer as a comparison group. Outcomes included opioid prescriptions, any indicator of potential prescription opioid misuse, and SUDs within 1 year posttherapy. Outcomes were compared between survivors and noncancer peers in bivariate and adjusted analyses, stratified by off-therapy age (children: 0-11 years; adolescents: 12-17 years; young adults: 18-28 years). All statistical tests were 2-sided. RESULTS: A higher proportion of survivors than noncancer peers filled opioid prescriptions (children: 12.7% vs 2.0%; adolescents: 22.9% vs 7.7%; young adults: 26.0% vs 11.9%). In models adjusting for sociodemographic factors and health status, survivors remained 74.4%-404.8% more likely than noncancer peer to fill opioid prescriptions (P < .001). The prevalence of potential misuse or SUDs was low, with 1.4% of child, 4.7% of adolescent, and 9.4% of young adult survivors fulfilling at least 1 criterion; however, it was higher than noncancer peers (0.1%, 1.4%, and 4.3%, respectively). In adjusted models, the likelihood of potential misuse among survivors remained at least 2 times higher than that among noncancer peers (P < .001), and the difference in SUDs became nonstatistically significant. CONCLUSION: Statistically significantly higher rates of opioid prescriptions and potential misuse were found among pediatric cancer survivors within 1 year posttherapy as compared with peers without cancer.
BACKGROUND: Pediatric cancer survivors often have pain, which may be managed with opioids. We examined the prevalence of opioid prescriptions, potential misuse, and substance use disorders (SUDs) among pediatric cancer survivors during the first year posttherapy. METHODS: Using MarketScan Commercial Database, we identified 8969 survivors (aged 21 years or younger at diagnosis) who completed cancer therapy in 2009-2018 and remained continuously enrolled for at least 1 year posttherapy and 44 845 age-, sex-, and region-matched enrollees without cancer as a comparison group. Outcomes included opioid prescriptions, any indicator of potential prescription opioid misuse, and SUDs within 1 year posttherapy. Outcomes were compared between survivors and noncancer peers in bivariate and adjusted analyses, stratified by off-therapy age (children: 0-11 years; adolescents: 12-17 years; young adults: 18-28 years). All statistical tests were 2-sided. RESULTS: A higher proportion of survivors than noncancer peers filled opioid prescriptions (children: 12.7% vs 2.0%; adolescents: 22.9% vs 7.7%; young adults: 26.0% vs 11.9%). In models adjusting for sociodemographic factors and health status, survivors remained 74.4%-404.8% more likely than noncancer peer to fill opioid prescriptions (P < .001). The prevalence of potential misuse or SUDs was low, with 1.4% of child, 4.7% of adolescent, and 9.4% of young adult survivors fulfilling at least 1 criterion; however, it was higher than noncancer peers (0.1%, 1.4%, and 4.3%, respectively). In adjusted models, the likelihood of potential misuse among survivors remained at least 2 times higher than that among noncancer peers (P < .001), and the difference in SUDs became nonstatistically significant. CONCLUSION: Statistically significantly higher rates of opioid prescriptions and potential misuse were found among pediatric cancer survivors within 1 year posttherapy as compared with peers without cancer.
Authors: Elizabeth Ward; Carol DeSantis; Anthony Robbins; Betsy Kohler; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2014-01-31 Impact factor: 508.702
Authors: Xu Ji; Jordan Gilleland Marchak; Ann C Mertens; Kimberly A Curseen; Ali J Zarrabi; Janet R Cummings Journal: Cancer Date: 2021-08-11 Impact factor: 6.860
Authors: Kris Ann P Schultz; Kirsten K Ness; John Whitton; Christopher Recklitis; Brad Zebrack; Leslie L Robison; Lonnie Zeltzer; Ann C Mertens Journal: J Clin Oncol Date: 2007-08-20 Impact factor: 50.717
Authors: Xin Hu; Katharine E Brock; Karen E Effinger; Bo Zhang; Ilana Graetz; Joseph Lipscomb; Xu Ji Journal: JAMA Oncol Date: 2022-09-08 Impact factor: 33.006