{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:01:33Z","timestamp":1791558093661,"version":"4.3.4"},"reference-count":75,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T00:00:00Z","timestamp":1633910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cancer survivors receive more long\u2010term opioid therapy (LTOT) than people without cancer, but the safety of LTOT prescribing is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Opioid\u2010naive adults aged \u226566 years who had been diagnosed in 2008\u20102015 with breast, lung, head and neck, or colorectal cancer were identified with data from Surveillance, Epidemiology, and End Results cancer registries linked with Medicare claims. Survivors with 1 or more LTOT episodes (\u226590 consecutive days) occurring \u22651 year after their cancer diagnosis and before censoring at hospice entry, another cancer diagnosis, 6 months before death, or December 2016 were included. The safety of prescribing during the first 90 days of the first LTOT episode was measured during follow\u2010up. As a positive safety indicator, the proportion of survivors with concurrent nonopioid pain management was measured. Indicators of less safe prescribing were the proportion of survivors with a high average daily opioid dose (\u226590 morphine milligram equivalents) and the proportion of survivors with concurrent benzodiazepine dispensing. Multivariable logistic regression analyses were conducted to identify clinical predictors of each safety outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 3628 cancer survivors received LTOT during follow\u2010up (median duration, 4.9 months; interquartile range, 3.5\u20108.0 months). Seventy\u2010two percent of the survivors received multimodal pain management concurrently with LTOT. Eight percent of the survivors had high\u2010dose opioid prescriptions; 25% of the survivors received benzodiazepines during LTOT. Multivariable analyses identified variations in safety measures by multiple clinical factors, although none were consistently significant across outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>To improve safe LTOT prescribing for survivors, efforts should focus on increasing multimodal pain management and reducing inappropriate benzodiazepine prescribing. Different clinical predictors of each outcome suggest different drivers of safe prescribing.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33963","type":"journal-article","created":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T14:42:05Z","timestamp":1634222525000},"page":"570-578","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Safety of opioid prescribing among older cancer survivors"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4515-6004","authenticated-orcid":false,"given":"Talya","family":"Salz","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akriti","family":"Mishra Meza","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee L.","family":"Gennarelli","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2423-2220","authenticated-orcid":false,"given":"Allison","family":"Lipitz\u2010Snyderman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9097-3620","authenticated-orcid":false,"given":"Natalie","family":"Moryl","sequence":"additional","affiliation":[{"name":"Department of Medicine Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn Ries","family":"Tringale","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise M.","family":"Boudreau","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuja","family":"Kriplani","sequence":"additional","affiliation":[{"name":"Department of Medicine Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sankeerth","family":"Jinna","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Korenstein","sequence":"additional","affiliation":[{"name":"Department of Medicine Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.12.340"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00938"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30839"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.74.1363"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26478"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.08.015"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.19.00081"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1464"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2015.11.033"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12100"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.52.4611"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.955"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.18.00781"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-016-1529-6"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S86983"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2016.00144"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0897190013515001"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.03.040"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2012.11.018"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h2698"},{"key":"e_1_2_8_22_1","first-page":"1","article-title":"Increase in fatal poisonings involving opioid analgesics in the United States, 1999\u20102006","volume":"22","author":"Warner M","year":"2009","journal-title":"NCHS Data Brief"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181c43103"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2559"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2011.06.008"},{"key":"e_1_2_8_26_1","first-page":"648","article-title":"Potential misuse and inappropriate prescription practices involving opioid analgesics","volume":"19","author":"Liu Y","year":"2013","journal-title":"Am J Manag Care"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318293c2c0"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2012\/15\/E1"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2012\/15\/ES9"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2008.00204.x"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2012\/15\/ES67"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2016.014837"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200208001-00002"},{"key":"e_1_2_8_34_1","first-page":"3","article-title":"Updated overview of the SEER\u2010Medicare data: enhanced content and applications","volume":"2020","author":"Enewold L","year":"2020","journal-title":"J Natl Cancer Inst Monogr"},{"key":"e_1_2_8_35_1","volume-title":"Overview of the SEER program"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(99)00070-6"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnz242"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818783964"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.5037\/jomr.2012.3101"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdm056"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25761"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2018.11.019"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2013.03.013"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2015.0140"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28695"},{"key":"e_1_2_8_46_1","volume-title":"Cancer Treatment & Survivorship Facts & Figures 2019\u20102021","author":"American Cancer Society","year":"2019"},{"key":"e_1_2_8_47_1","volume-title":"Cancer Facts & Figures 2020","author":"American Cancer Society","year":"2020"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4917"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnx203"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(00)00256-0"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(93)90103-8"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.02.024"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2019.05.019"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68700-X"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-199603000-00009"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djz233"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djz200"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.8325"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18-1243"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1080\/15360288.2018.1479328"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32484"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j760"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.0919"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.28557"},{"key":"e_1_2_8_65_1","volume-title":"From Cancer Patient to Cancer Survivor: Lost in Transition","author":"Institute of Medicine and National Research Council","year":"2006"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31852"},{"key":"e_1_2_8_67_1","volume-title":"Models of Cancer Survivorship Care","author":"Viswanathan M","year":"2014"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-013-0281-y"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-020-00911-w"},{"key":"e_1_2_8_70_1","first-page":"CD012425","article-title":"Follow\u2010up strategies following completion of primary cancer treatment in adult cancer survivors","volume":"2019","author":"H\u00f8eg BL","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_71_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-015-0440-4"},{"key":"e_1_2_8_72_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.11.9859"},{"key":"e_1_2_8_73_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-011-0181-y"},{"key":"e_1_2_8_74_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-007-0497-5"},{"key":"e_1_2_8_75_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.68.5206"},{"key":"e_1_2_8_76_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.1574"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.33963","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.33963","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.33963","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T13:46:47Z","timestamp":1760276807000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.33963"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,11]]},"references-count":75,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1002\/cncr.33963"],"URL":"https:\/\/doi.org\/10.1002\/cncr.33963","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,11]]},"assertion":[{"value":"2021-02-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}