Opioid use among cancer patients does not appear to be leading to the steep increase of overdoses seen in the general public, according to study by researchers at the Duke Cancer Institute.
The study, presented Sept. 28 to the ASCO Quality Care Symposium in Phoenix, found that death from opioids are 10 times less likely to occur in cancer patients compared to the general population.
During a 10-year period from 2006-16, the researchers found that opioid deaths in the general population increased from 5.33 to 8.97 per 100,000 people. For cancer patients, the rate rose from 0.52 to 0.66 per 100,000.
In all, 895 cancer patients died as a result of opioids over that period, compared to 193,500 in the non-cancer population.
"Virtually no cancer patient I talk to wants to take these medications to get through treatment," said Fumiko Chino, M.D., a radiation oncologist at Duke Cancer Institute who presented the findings during the press program of the symposium.
"I have to cajole them to take opioids for pain management," Chino said. "But this study should give doctors some reassurance that the rate of opioid-related deaths among cancer patients is very low, and their patients are not going to be a statistic in the opioid epidemic."
Chino and colleagues use de-identified death certificate data from the National Center for Health Statistics, which cites one underlying cause of death and up to 20 contributing causes, as well as demographic data.
All deaths due to opioids were included from 2006-2016; if present, cancer was noted as a contributing cause. Opioid death incidence was calculated from both the U.S. and estimated cancer survivor population.
"We know the United States is in a bad place with the opioid epidemic, and the main concern with oncologists is whether we need to be more restrictive in prescribing these medications to cancer patients given the rapid rise in deaths in the general population," Chino said.
"But part of our ability to successfully treat cancer includes the use of these medications," she said. "This research shows that for this vulnerable population, the risk of overdose death is quite low."
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