{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:17:35Z","timestamp":1783430255425,"version":"3.54.6"},"reference-count":57,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004836","name":"Danish Council for Independent Research","doi-asserted-by":"publisher","award":["1030-000052B"],"award-info":[{"award-number":["1030-000052B"]}],"id":[{"id":"10.13039\/501100004836","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008363","name":"Danish Cancer Society","doi-asserted-by":"publisher","award":["R379-A22231"],"award-info":[{"award-number":["R379-A22231"]}],"id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pain is a common, long-lasting effect of breast cancer treatment, but adequate pain management can be a challenge in survivorship care. Opioids remain important for acute and chronic pain, yet prolonged use carries risks of dependence and overdose. Denmark has historically had high opioid prescription rates, but the duration, strength, and intensity of use among breast cancer survivors is not well described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide registry-based study of 84\u2009610 Danish women diagnosed with stage I to III breast cancer between 1997 and 2020. We described temporal trends in opioid prescribing and examined associations between sociodemographic and clinical characteristics and 5 potentially harmful opioid-related outcomes after breast cancer: new and prolonged use, long-term use, long-term strong use, concurrent use with sedative hypnotics, and diagnosed substance-related disorder or overdose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Within 1 year of diagnosis, 18% of women filled at least 1 opioid prescription; this proportion declined steadily after 2015. Codeine, the most common initial opioid in the late 1990s, was gradually replaced by tramadol, morphine, and oxycodone. Across the cohort, 6.1% had long-term use, 2.0% had long-term strong use, 3.6% had concurrent opioid and sedative hypnotic use, and 0.4% developed a substance-related disorder or overdose. Among 74\u2009771 opioid-na\u00efve patients, 1.7% became new and prolonged users. The odds of these opioid-related behaviors were higher among women with socioeconomic hardships, psychiatric morbidity, comorbidity, and advanced disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Opioid use after breast cancer was uncommon and declined over time in Denmark. Nonetheless, social and clinical disparities persisted, highlighting the importance of survivorship care that balances safe prescribing with adequate pain management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag052","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T12:39:11Z","timestamp":1771936751000},"page":"1257-1265","source":"Crossref","is-referenced-by-count":0,"title":["Opioid use after breast cancer in Denmark: a nationwide study of social and clinical factors"],"prefix":"10.1093","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5536-7649","authenticated-orcid":false,"given":"Kirsten M","family":"Woolpert","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital , Aarhus,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9433-6442","authenticated-orcid":false,"given":"Anders","family":"Kj\u00e6rsgaard","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital , Aarhus,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Schapira","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Oncology, Stanford University School of Medicine , Palo Alto, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4299-7040","authenticated-orcid":false,"given":"Henrik Toft","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital , Aarhus,","place":["Denmark"]},{"name":"Department of Medicine, Division of Oncology, Stanford University School of Medicine , Palo Alto, CA,","place":["United States"]},{"name":"Center for Population Medicine, Aarhus University and Aarhus University Hospital , Aarhus,","place":["Denmark"]},{"name":"Clinical Excellence Research Center, Stanford University , Palo Alto, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9738-2284","authenticated-orcid":false,"given":"Deirdre","family":"Cronin-Fenton","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital , 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