Cancer Survivors and Opioid Use During Survivorship - A Scoping Review
Author(s)
Albert M. Truong, PharmD1, Duc Pham, BA2, Trevor Sproule, BS, MS1, Erica R. Brody, MPH, MSLS3, Vasco M. Pontinha, MA, MSc, PhD1;
1Virginia Commonwealth University, Department of Pharmacotherapy and Outcomes Science, Richmond, VA, USA, 2University of Minnesota, Minneapolis, MN, USA, 3Virginia Commonwealth University, VCU Libraries | Health Sciences Library, Richmond, VA, USA
1Virginia Commonwealth University, Department of Pharmacotherapy and Outcomes Science, Richmond, VA, USA, 2University of Minnesota, Minneapolis, MN, USA, 3Virginia Commonwealth University, VCU Libraries | Health Sciences Library, Richmond, VA, USA
OBJECTIVES: Opioids are crucial for managing cancer-related pain, but the long-term effects in cancer survivors are under-researched. With over 18 million cancer survivors in the U.S., understanding opioid exposure in this population is crucial. This review characterized how opioid usage and its consequences are measured in cancer survivors and how survivorship has been defined in previous research.
METHODS: This scoping review characterized opioid use among cancer survivors, definitions of cancer survivorship, and the consequences of opioid exposure during survivorship. Studies were identified in Medline (OVID) and Embase databases using predefined inclusion/exclusion criteria. Covidence was used to deduplicate, facilitate title/abstract and full-text review, and resolve conflicts.
RESULTS: Out of 9,532 articles retrieved, 6,837 underwent title and abstract screening, 668 underwent full-text review, and a total of 205 studies were included.Survivorship definitions varied, with cancer patients (n=106) and survivors post-curative intent treatment (n=40) inconsistently defined. Opioid usage was reported with inconsistent terminology, such as “chronic,” “persistent,” “long-term,” and “prolonged,” with minimum durations ranging from 3 to 12 months (n=84), with 19 studies reporting usage one year after treatment. Many studies did not specify the period of opioid usage. Additionally, opioid use in cancer versus non-cancer patients (n=36), development of opioid use disorder (n=6), and overall survival (n=10) were evaluated.
CONCLUSIONS: Numerous studies reported evidence of persistent opioid use one year after treatment. However, definitions of cancer survivorship and opioid use, including therapy duration and thresholds for problematic use, vary across studies. There is also limited evidence characterizing the timing of opioid exposure in specific phases of survivorship-before, during, and after treatment. A strong evidence foundation is urgently needed in cancer survivorship research to optimize pain management and minimize the potential harms of continued opioid exposure, including opioid- and cancer-related harm.
METHODS: This scoping review characterized opioid use among cancer survivors, definitions of cancer survivorship, and the consequences of opioid exposure during survivorship. Studies were identified in Medline (OVID) and Embase databases using predefined inclusion/exclusion criteria. Covidence was used to deduplicate, facilitate title/abstract and full-text review, and resolve conflicts.
RESULTS: Out of 9,532 articles retrieved, 6,837 underwent title and abstract screening, 668 underwent full-text review, and a total of 205 studies were included.Survivorship definitions varied, with cancer patients (n=106) and survivors post-curative intent treatment (n=40) inconsistently defined. Opioid usage was reported with inconsistent terminology, such as “chronic,” “persistent,” “long-term,” and “prolonged,” with minimum durations ranging from 3 to 12 months (n=84), with 19 studies reporting usage one year after treatment. Many studies did not specify the period of opioid usage. Additionally, opioid use in cancer versus non-cancer patients (n=36), development of opioid use disorder (n=6), and overall survival (n=10) were evaluated.
CONCLUSIONS: Numerous studies reported evidence of persistent opioid use one year after treatment. However, definitions of cancer survivorship and opioid use, including therapy duration and thresholds for problematic use, vary across studies. There is also limited evidence characterizing the timing of opioid exposure in specific phases of survivorship-before, during, and after treatment. A strong evidence foundation is urgently needed in cancer survivorship research to optimize pain management and minimize the potential harms of continued opioid exposure, including opioid- and cancer-related harm.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HSD26
Topic
Health Service Delivery & Process of Care
Disease
SDC: Oncology, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)