Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, USA.
New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, USA.
J Gen Intern Med. 2024 Nov;39(14):2698-2707. doi: 10.1007/s11606-024-08940-2. Epub 2024 Jul 19.
Substance misuse is common among cancer survivors and can negatively impact cancer outcomes.
We conducted a cross-sectional study using National Survey on Drug Use and Health data for 2015 to 2020. We included adult respondents with a history of solid tumor cancer. We calculated the weighted prevalence and corresponding SEs (both expressed as percentages) of substance (alcohol, opioid, sedative, stimulant, other) misuse for respondents with any history of solid tumor cancer and, in secondary analyses, respondents diagnosed with cancer in the prior 12 months.
The study included 6,101 respondents with any history of cancer, 1,437 diagnosed in the prior 12 months. Alcohol was the most commonly misused substance. The average prevalence of alcohol misuse was 14.4% (SE 0.60%) across cancer types; it was markedly more common among people with a history or cervical (24.2% [3.0%]) or head and neck cancer (27.4% [7.1%]). The next most common form of substance misuse was opioid misuse (average prevalence: 2.7% [0.25%]). As with alcohol misuse, the prevalence of opioid misuse was higher among those with a lifetime history of cervical cancer (5% [1%]) or head and neck cancer (5% [3%]). Results were generally consistent among cancer survivors diagnosed in the prior 12 months.
There is a clear opportunity to address substance misuse-particularly alcohol misuse-among cancer survivors. Such efforts should focus on populations with a high prevalence of substance misuse (e.g., cervical and head and neck cancer survivors) and have strong potential to improve cancer-specific and overall health outcomes.
物质滥用在癌症幸存者中很常见，会对癌症结果产生负面影响。
我们使用 2015 年至 2020 年全国药物使用与健康调查的数据进行了一项横断面研究。我们纳入了有实体瘤癌症病史的成年受访者。我们计算了有任何实体瘤癌症病史的受访者（均以百分比表示）和在过去 12 个月内被诊断为癌症的受访者（均以百分比表示）中物质（酒精、阿片类药物、镇静剂、兴奋剂、其他）滥用的加权患病率和相应的 SE。
该研究纳入了 6101 名有癌症病史的受访者，其中 1437 名受访者在过去 12 个月内被诊断为癌症。酒精是最常被滥用的物质。在所有癌症类型中，酒精滥用的平均患病率为 14.4%（SE 0.60%）；在有宫颈癌（24.2%[3.0%]）或头颈部癌症（27.4%[7.1%]）病史的人群中更为常见。下一个最常见的物质滥用形式是阿片类药物滥用（平均患病率：2.7%[0.25%]）。与酒精滥用一样，有宫颈癌（5%[1%]）或头颈部癌症（5%[3%]）病史的人，阿片类药物滥用的患病率更高。在过去 12 个月内被诊断为癌症的癌症幸存者中，结果基本一致。
在癌症幸存者中，有明确的机会解决物质滥用问题——特别是酒精滥用问题。此类工作应侧重于物质滥用发生率较高的人群（例如，宫颈癌和头颈部癌症幸存者），并有可能改善癌症特异性和总体健康结果。
