Opioid Use in Patients with Cervical Cancer at Two Urban Medical Centers

Abstract Purpose/Objectives Cervical cancer patients are at high risk for opioid use. This study aimed to characterize opioid prescribing patterns at two urban hospitals. Methods Data from patients with cervical cancer treated with curative intent from 2011-2018 were retrospectively collected. Women with unrelated chronic opioid use prior to diagnosis, persistent/recurrent disease at 3 months following initiation of treatment, or initiation of opioids >6 months after treatment were excluded. Demographics, disease characteristics, treatment, and outpatient prescription practices were collected. Endpoints included duration of opioid use ≥6 and ≥12 months. Results There were 106 women included, of whom 83% received definitive radiation. Most patients (n=91, 85.8%) received outpatient opioids. Most common timing of prescriptions were prior to cancer therapy (35.9%), post-procedure (26.4%), and during RT (17.0%). Median duration was 3 [IQR 1-11] months; 35.2% of these patients received opioids ≥6 months and 22% received opioids ≥12 months. Greater FIGO stage, recurrent/residual disease, initiation of opioids before treatment, history of depression or anxiety, and use of gabapentin or steroids were associated with long term opioid use. Conclusion Most patients were prescribed outpatient opioids, many of whom used opioids for over 12 months. Improvement in provider communication and education, increased post-treatment monitoring, and further evaluation of non-opioid therapies are needed in this patient population to reduce long-term opioid use.