{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:33:13Z","timestamp":1780579993000,"version":"3.54.1"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cancer treatment is often complicated by co\u2010occurring substance dependence such as alcohol, cannabis, opioids, amphetamines, and tobacco. The objective of this study was to analyze the association between substance use (alcohol, cannabis, opioids, amphetamines, and tobacco) and mortality among cancer patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study used de\u2010identified data from the University of California, San Diego Health on 22,763 cancer patients aged \u2265\u00a018\u00a0years. Substance dependance post\u2010diagnosis was identified based on clinical observations from electronic health records. Tumor staging was determined using the TNM system, with missing data imputed via biomarker\u2010based regression. Cox proportional hazards models were computed to assess severity\u2010adjusted associations between substance dependance, by type, and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cannabis dependence was not significantly associated with mortality. Alcohol, tobacco, opioid, and amphetamine dependence were linked to increased mortality in both unadjusted and adjusted models. Adjusting for tumor stage reduced hazard ratios for opioid and tobacco dependence, suggesting stage as a confounding factor. Alcohol and opioid dependence remained significant predictors of mortality, while findings for cannabis and amphetamine were limited by small sample sizes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Alcohol and opioid dependence in cancer patients was observed to be a significant predictor of mortality after adjusting for disease severity, emphasizing the need for targeted interventions among this subpopulation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70243","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T17:07:22Z","timestamp":1753808842000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Influence of Substance Use Disorders on Mortality in a Systemwide Cohort of Cancer Patients"],"prefix":"10.1002","volume":"34","author":[{"given":"Shawnly","family":"Khoyilar","sequence":"first","affiliation":[{"name":"University of California  San Diego California USA"},{"name":"School of Medicine  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidya","family":"Purushothaman","sequence":"additional","affiliation":[{"name":"San Diego Supercomputer Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael E.","family":"Cuomo","sequence":"additional","affiliation":[{"name":"University of California  San Diego California USA"},{"name":"School of Medicine  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21820"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soncn.2016.05.012"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6190"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpain.2021.691720"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14225720"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm.2017.08.05"},{"key":"e_1_2_10_8_1","volume-title":"Marijuana as Medicine? 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I.","year":"2011","journal-title":"Journal of Clinical Oncology"},{"key":"e_1_2_10_15_1","volume-title":"National Survey on Drug Use and Health","author":"Substance Abuse and Mental Health Services Administration","year":"2021"},{"issue":"2","key":"e_1_2_10_16_1","first-page":"282","article-title":"Decreasing Black\u2013White Disparities in Colorectal Cancer Incidence and Stage at Presentation in the United States","volume":"25","author":"May F. P.","year":"2016","journal-title":"Cancer Epidemiology, Biomarkers & Prevention"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13093173"},{"issue":"11","key":"e_1_2_10_18_1","first-page":"891","article-title":"\u201cPlace des amph\u00e9tamines en canc\u00e9rologie: Une revue de la litt\u00e9rature\u201d [Role of amphetamines in cancerology : A review of the literature]","volume":"83","author":"Reich M. 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