Heavy alcohol use and tobacco use are known to increase the risk of some cancers, but less is known of what happens to people who have a substance use problem after surviving cancer. A report in JAMA Oncology now suggests that substance use disorder is more prevalent among survivors of head and neck cancer, esophageal and gastric cancer, cervical cancer, and melanoma than survivors of breast, prostate, and colon cancers.
“Our findings underscore the need to understand and address the needs of cancer survivors with comorbid [substance use disorder],” wrote Katie F. Jones, Ph.D., of the VA Boston Healthcare System and colleagues. “Our results also highlight certain populations of cancer survivors who would likely benefit the most from such interventions based on their higher prevalence of SUD, including those with a lifetime history of and those with recently diagnosed cervical and head and neck cancers.”
For the cross-sectional study of adult cancer survivors, Jones and colleagues analyzed data collected between 2015 and 2020 as part of the annual National Survey on Drug Use and Health (NSDUH). The researchers defined substance use disorder (SUD) as “meeting at least 1 of 4 DSM-IV criteria for abuse or at least 3 of 6 DSM-IV criteria for dependence.” The researchers calculated the weighted population prevalence of SUD by cancer type.
A total of 6,101 adult cancer survivors (about 57% aged 65 and older; 62% female) were included in the analysis. Across cancers, the weighted prevalence of active SUD was 3.83%, and alcohol use disorder was the most common SUD, with a weighted prevalence of 2.78%. The prevalence of SUD was higher among survivors of the following:
- Esophageal and gastric cancer (9.42%)
- Head and neck cancer (9.36%)
- Cervical cancer (6.24%)
- Melanoma (6.20%)
In a secondary analysis of 1,437 survivors who were diagnosed with cancer within 12 months of participating in the NSDUH, the overall prevalence of SUD was similar as the main cohort (3.81%); however, the prevalence of SUD among the survivors of head and neck cancer and cervical cancer was 18.73% and 15.70%, respectively.
The authors highlighted several limitations of the study—for instance, the overall SUD prevalence in cancer survivors was lower than previous reports of SUD prevalence in the general population; additionally, the authors noted that they did not have access to information about the prognosis of those who had been diagnosed with cancer.
“[T]he findings of the present study underscore the need for research on models of care that integrate addiction services and expertise into the care of cancer populations with a high prevalence of [substance use disorder] to address their complex and intersecting needs,” Jones and colleagues wrote.
For related articles, see the Psychiatric News article “Special Report: Psychiatrists Critical in Screening, Treatment of Alcohol Use Disorder.”
(Image: iStock/AlexanderFord)
Look for Your 2024 APA Election Ballot!
All voting members should have received their electronic ballot for APA’s 2024 election by now. If you haven’t seen yours yet, take a moment to look for it in your email inbox and vote. You can also vote on the APA election website by entering your APA username and password. Detailed information about the candidates and campaigning guidelines can also be accessed on the site. Help shape the future of APA by casting your ballot today.