In a study reported in JAMA Oncology, Jones et al found a prevalence of active substance use disorders of 3.8% among U.S. adult survivors of solid tumor cancers, with higher rates among those with head/neck, esophageal/gastric, and cervical cancers as well as melanoma.
Study Details
The study used data from the National Survey on Drug Use and Health for 2015 through 2020 to identify adults with a history of solid tumor cancer. Substance use disorder was defined as meeting at least one of four Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for abuse or at least three of six criteria for dependence. Substances included alcohol, cannabis, opioids, stimulants, and sedatives. Active substance use disorder was defined as a disorder diagnosed within the past 12 months.
Key Findings
Data from 6,101 survivors (56.9%, aged ≥ 65; 61.6%, female) were included in the analysis. Among lifetime cancer survivors, the prevalence of active substance use disorder was 3.83% (standard error [SE] = 0.3%).
Substance use disorder was most prevalent in survivors of head and neck cancer (9.36% [SE = 2.5%], including mouth, tongue, lip, throat, and pharyngeal cancers); esophageal and gastric cancer (9.42% [SE = 5.5%]); cervical cancer (6.2% [SE = 1.41%]); and melanoma (6.20% [SE = 1.3%]).
Alcohol use disorder was the most common substance use disorder overall (2.8% [SE = 0.3%]) and was the most common substance use disorder among survivors of head and neck cancer, cervical cancer, and melanoma. Cannabis use disorder was the most common substance use disorder among survivors of esophageal and gastric cancers (9.42% [SE = 5.5%]).
Among patients diagnosed with cancer in the past 12 months, the overall prevalence of active substance use disorder was 3.8% (SE = 0.7%), a prevalence similar to that in the lifetime cancer survivor group. However, among these patients, active substance use disorder prevalence was higher in head and neck cancer survivors (18.7% [SE = 10.3%]) and cervical cancer survivors (15.7% [SE = 5.4%]). The distribution of substance use disorders also differed from that in the lifetime survivor group; eg, sedative use was the most common substance use disorder among head and neck cancer survivors (9.8% [SE = 9.2%]).
The investigators concluded: “Findings of this study suggest that substance use disorder prevalence is higher among survivors of certain types of cancer; this information could be used to identify cancer survivors who may benefit from integrated cancer and substance use disorder care. Future efforts to understand and address the needs of adult cancer survivors with comorbid substance use disorder should prioritize cancer populations in which substance use disorder prevalence is high.”
Devon K. Check, PhD, of the Department of Population Health Sciences, Duke University School of Medicine, is the corresponding author of the JAMA Oncology article.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
