Increasing cancer mortality among opioid-dependent persons in Australia: a new public health challenge for a disadvantaged population

Randall, Deborah, Degenhardt, Louisa, Vajdic, Claire M., Burns, Lucy, Hall, Wayne D., Law, Matthew and Butler, Tony (2011) Increasing cancer mortality among opioid-dependent persons in Australia: a new public health challenge for a disadvantaged population. Australian and New Zealand Journal of Public Health, 35 3: 220-225. doi:10.1111/j.1753-6405.2011.00682.x


Author Randall, Deborah
Degenhardt, Louisa
Vajdic, Claire M.
Burns, Lucy
Hall, Wayne D.
Law, Matthew
Butler, Tony
Title Increasing cancer mortality among opioid-dependent persons in Australia: a new public health challenge for a disadvantaged population
Journal name Australian and New Zealand Journal of Public Health   Check publisher's open access policy
ISSN 1326-0200
1753-6405
Publication date 2011-06
Sub-type Article (original research)
DOI 10.1111/j.1753-6405.2011.00682.x
Volume 35
Issue 3
Start page 220
End page 225
Total pages 6
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2012
Language eng
Formatted abstract
Objective: To examine cancer mortality in a population-based cohort of opioid-dependent persons.

Methods: New South Wales opioid substitution therapy (OST) program registrants from 1985 to 2005 (n=43,789) were probabilistically linked to the National Death Index. Crude and standardised mortality rates and standardised mortality ratios (SMRs) were calculated.

Results: The crude cancer mortality rate increased from 4 to 65 deaths per 100,000 person-years (p trend <0.001). Overall, OST registrants were 1.7 times more likely to die of cancer than the general population (SMR 95% CI 1.4–1.9). Site-specific SMRs were significantly elevated for lung cancer (3.6, 95% CI 2.8–4.6), liver cancer (6.9, 95% CI 4.3–10.5), and anogenital cancers (2.8, 95% CI 1.3–5.3), and significantly reduced for breast cancer (0.4, 95% CI 0.1–0.9).

Conclusions: Cancer is an increasingly important cause of death among OST registrants as they live longer with their dependency. The site-specific excess deaths suggest the role of tobacco, alcohol, and infection with hepatitis C and human papillomavirus.

Implications: The OST setting may be a useful setting for the delivery of programs aimed at detection of precursor lesions, reducing exposure to established carcinogens, and treatment for those with HCV infection. Such targeted steps are likely to reduce the future cancer burden in this population.
Keyword Neoplasms/mortality
Cause of death/trends
Substance abuse
Intravenous/mortality
Injecting drug-users
Methadone-maintenance
Record linkage
HIV-infection
Addicts
Alcohol
Cohort
Death
Retention
Pregnancy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
 
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Created: Wed, 19 Oct 2011, 12:02:18 EST by Wayne Hall on behalf of School of Public Health