MacDonald Madeline, Shah Shreni, Swanson Justin, Song Ethan, Ahsan Tanzila, Pabbathi Smitha, Mhaskar Rahul, Mirza Abu-Sayeef
Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA.
College of Public Health, University of South Florida, Tampa, USA.
Cureus. 2020 Aug 27;12(8):e10083. doi: 10.7759/cureus.10083.
Introduction Substance use disorders occur in about 5% of the cancer population and can decrease treatment adherence, impede pain management, and undermine a cancer survivor's network of social support. Although current literature demonstrates substance use is associated with socioeconomic disparity, there is limited research on the prevalence of alcohol, tobacco, and illicit drug use among uninsured cancer survivors in the United States. Our multicenter cross-sectional study describes the prevalence of substance use in uninsured cancer survivors in the Tampa Bay Area. Methods A comprehensive retrospective chart review of electronic medical records and paper charts was conducted at nine free clinics in the Tampa Bay Area of Florida between January 1, 2016, and December 31, 2017. Substance use prevalence was compared between uninsured cancer survivors and uninsured patients without reported cancer history after adjusting for available demographic risk factors. Results There were 222 patients with a history of cancer and 6,768 patients without a history of cancer included for analysis. Cancer survivors had a median age of 55 years (interquartile range 48-61 years), were mostly female (n = 146, 66.1%), and of Hispanic ethnicity (n = 94, 52.5%). Cancer survivors were more likely to be current smokers (n = 42, 25.1%) compared to patients without a cancer history (n = 759, 16.1%). Patients with a history of cancer were more likely to be current drinkers (n = 34, 26%) compared to non-cancer patients (n = 942, 22.9%). There was no significant difference in illicit drug use history between the two groups. Conclusions Our study demonstrates that uninsured cancer survivors are more likely to be smokers and alcohol consumers than uninsured patients without a history of cancer. There was no significant difference in illicit drug use in cancer survivors and patients without a history of cancer. Future educational interventions should target substance use among uninsured cancer survivors.
引言
物质使用障碍在约5%的癌症患者中出现，会降低治疗依从性、阻碍疼痛管理并破坏癌症幸存者的社会支持网络。尽管当前文献表明物质使用与社会经济差异有关，但关于美国未参保癌症幸存者中酒精、烟草和非法药物使用流行情况的研究有限。我们的多中心横断面研究描述了坦帕湾地区未参保癌症幸存者的物质使用流行情况。
方法
2016年1月1日至2017年12月31日期间，在佛罗里达州坦帕湾地区的9家免费诊所对电子病历和纸质病历进行了全面的回顾性图表审查。在调整了可用的人口统计学危险因素后，比较了未参保癌症幸存者和无癌症病史报告的未参保患者之间的物质使用流行情况。
结果
共有222名有癌症病史的患者和6768名无癌症病史的患者纳入分析。癌症幸存者的中位年龄为55岁（四分位间距48 - 61岁），大多数为女性（n = 146，66.1%），且为西班牙裔（n = 94，52.5%）。与无癌症病史的患者（n = 759，16.1%）相比，癌症幸存者更可能是当前吸烟者（n = 42，25.1%）。有癌症病史的患者比无癌症患者（n = 942，22.9%）更可能是当前饮酒者（n = 34，26%）。两组之间非法药物使用史无显著差异。
结论
我们的研究表明，未参保癌症幸存者比无癌症病史的未参保患者更可能是吸烟者和饮酒者。癌症幸存者和无癌症病史患者在非法药物使用方面无显著差异。未来的教育干预应针对未参保癌症幸存者中的物质使用情况。
