Despite the infrequency of urine drug test ordering, greater than half of all urine drug tests results were abnormal among outpatients with advanced cancer, according to a study published in the journal Cancer.1

Because limited data on the use and outcomes of urine drug tests among patients with advanced cancer exist, researchers sought to identify factors associated with urine drug test ordering and results in outpatients.

For the study, investigators retrospectively analyzed data from 1058 patients who attended an outpatient supportive care clinic between March 2014 and November 2015.

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Of those, 61 were receiving chronic opioid therapy and underwent urine drug testing. A control of group of 120 patients who did not undergo urine drug testing was identified for comparison.

Researchers found that age younger than 45 years (P <.001), positive Cut Down, Annoyed, Guilty, and Eye Opener (CAGE) questionnaire results (P =.002), early stage cancer or no evidence of disease status (P =.008), higher pain intensity (P <.001), and lower fatigue scores (P =.001) were significant predictors of urine drug test ordering.

Results further showed that 54% of the 61 patients had abnormal urine drug test results.

Among the 52 abnormal test results in 33 patients, 27% were abnormal because prescribed opioids were absent in urine and 25% were abnormal because unprescribed opioids were detected in urine.


1. Arthur JA, Edwards T, Lu Z, et al. Frequency, predictors, and outcomes of urine drug testing among patients with advanced cancer on chronic opioid therapy at an outpatient supportive care clinic. Cancer. 2016 Aug 10. doi: 10.1002/cncr.30240. [Epub ahead of print]