Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN, 55454-1015, USA.
Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, Mail code: 152, Bldg. 9, One Veterans Drive, Minneapolis, MN, 55417, USA.
J Cancer Surviv. 2023 Dec;17(6):1561-1570. doi: 10.1007/s11764-022-01215-x. Epub 2022 May 14.
Cancer survivors are at increased risk of pain due to their either cancer and/or treatments. Substances like alcohol may be used to self-medicate cancer pain; however, these substances pose their own health risks that may be more pronounced for cancer survivors.
We used cross-sectional data from the Behavioral Risk Factor Surveillance System (BRFSS) 2012-2019 to quantify the association between cancer pain and alcohol use. We used negative binomial regression, with interaction terms added to examine variations across age, sex, and race. We also examined whether alcohol use relates to cancer pain control status.
Cancer survivors with cancer pain were more likely to be younger, female, Black, and to have been diagnosed with breast cancer. Cancer pain was associated with lower alcohol consumption (incidence rate ratio (IRR): 0.88, confidence interval (CI): 0.77, 0.99). This association was primarily among people 65 and older, women, and white and Hispanic people. Cancer pain control status was not related to alcohol use.
Lower alcohol use among cancer survivors with pain has many possible explanations, including several alternative pain management strategies or a decrease in social engagement. Our findings of racial and gender disparities in cancer pain are consistent with the broader evidence on disparities in pain.
Cancer pain management for marginalized groups should be improved. Healthcare providers should screen cancer survivors for both pain and substance use, to prevent unhealthy self-medication behaviors.
由于癌症及其治疗，癌症幸存者面临更高的疼痛风险。酒精等物质可能被用于治疗癌症疼痛；然而，这些物质本身也存在健康风险，对于癌症幸存者来说可能更为明显。
我们使用了 2012 年至 2019 年行为风险因素监测系统（BRFSS）的横断面数据，来量化癌症疼痛与酒精使用之间的关联。我们使用负二项回归，并添加了交互项来检查年龄、性别和种族的差异。我们还检查了酒精使用是否与癌症疼痛控制状况有关。
有癌症疼痛的癌症幸存者更年轻、女性、黑人，且更可能被诊断为乳腺癌。癌症疼痛与较低的酒精摄入量相关（发病率比 (IRR)：0.88，置信区间 (CI)：0.77，0.99）。这种关联主要存在于 65 岁及以上的人群、女性以及白人和西班牙裔人群中。癌症疼痛控制状况与酒精使用无关。
有疼痛的癌症幸存者中酒精使用量较低可能有多种解释，包括使用了几种替代的疼痛管理策略，或社交参与度下降。我们发现癌症疼痛在种族和性别方面存在差异，这与疼痛方面的广泛证据一致。
应改善边缘化群体的癌症疼痛管理。医疗保健提供者应筛查癌症幸存者的疼痛和物质使用情况，以防止不健康的自我药物治疗行为。
