OBJECTIVES: Alcohol use disorder (AUD) can lead to poor outcomes among cancer survivors, including cancer recurrence and new malignancies. However, the burden of AUD in this population is not well characterized. This cross-sectional study evaluated the prevalence and correlates of AUD diagnoses among cancer survivors.

METHODS: We analyzed Merative MarketScan® commercial insurance and supplementary Medicare claims data (2011-2021). Individuals were included in the study if they had a prior malignant neoplasm diagnosis (index date) and 6-month continuous enrollment. Among eligible cancer survivors, we further identified individuals with an AUD diagnosis. We assessed AUD prevalence for each year among all cancer survivors and in specific subgroups and performed time trend analyses. Using data across all years, we compared demographic and clinical characteristics between cancer survivors with and without AUD and identified correlates of AUD diagnosis using multivariable logistic regressions.

RESULTS: Of 5,956,137 eligible cancer survivors, 105,778 (1.78%) had received an AUD diagnosis. The annual prevalence of AUD diagnosis increased from 0.78% in 2012 to 1.43% in 2021 (p<0.001). The prevalence of AUD in specific subgroups also increased over time, including among outpatients, inpatients, and individuals with alcohol-related cancers (i.e., oral cavity, pharynx, larynx, esophagus, stomach, liver, colorectum, and breast in females). Cancer survivors with AUD were younger (at index date), used more healthcare services, and had more physical and mental comorbidities compared to those without AUD. Multivariable analysis demonstrated that male sex, alcohol-related cancers, mental health diagnoses, and antidepressant or antipsychotic use were associated with over 2-3 times increased odds of a lifetime AUD diagnosis.

CONCLUSIONS: AUD diagnosis among US cancer survivors with private insurance has increased over time, mirroring trends in the general population. Cancer survivors should be screened and treated for AUD to mitigate the unique risks associated with alcohol use and misuse in this population.