In 2016, more than 40,000 American deaths were due to opioid overdose. Patients with cancer frequently use opioids for pain management, but the risk of overdose in this population is unknown. Researchers at the Duke Cancer Institute assessed the number of opioid-associated deaths in cancer patients over the past 10 years. The results of the study were presented at the 2018 American Society of Clinical Oncology (ASCO) Quality Care Symposium. 

The team collected de-identified death certificates including demographic data from 2006 to 2016 from the National Center for Health Statistics. They found that deaths from opioid overdose were 10 times less likely to occur in people with cancer than in the general population, with only 895 deaths due to opioids in the cancer population, compared with 193,500 deaths in the cancer-free population. However, there was a slight increase in the number of opioid deaths among patients with cancer — from 0.52 to 0.66 per 100,000 cancer patients.

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Notably, the patients with cancer who died from opioid overdose were demographically different from opioid overdose cases in the general population. Cancer patients were more likely to be older (median 57 years), higher educated (at least 1 year of college), women, non-Hispanic; less likely to be white, single; 22% had lung cancer, 12% had head and neck cancers, 11% had hematologic cancers, and 10% had GU cancers. The authors argue that the risk for opioid overdose among patients with cancer is different than the general population and should be considered when planning effective pain treatment.

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Chino FL, Kamal A, Chino JP. Opioid-associated deaths in patients with cancer: a population study of the opioid epidemic over the past 10 years. Poster presentation at: 2018 ASCO Quality care Symposium; September 28-29, 2018; Phoenix, AZ. Abstract 230.