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

Objective: To examine cancer mortality in a population-based cohort of opioiddependent 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 rate...

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Main Authors: Randall, D., Degenhardt, L., Vajdic, C., Burns, L., Hall, W., Law, M., Butler, Tony
Format: Journal Article
Published: 2011
Online Access:http://hdl.handle.net/20.500.11937/22390
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author Randall, D.
Degenhardt, L.
Vajdic, C.
Burns, L.
Hall, W.
Law, M.
Butler, Tony
author_facet Randall, D.
Degenhardt, L.
Vajdic, C.
Burns, L.
Hall, W.
Law, M.
Butler, Tony
author_sort Randall, D.
building Curtin Institutional Repository
collection Online Access
description Objective: To examine cancer mortality in a population-based cohort of opioiddependent 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). Sitespecifc SMRs were signifcantly 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 signifcantly 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-specifc 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. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.
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spelling curtin-20.500.11937-223902017-09-13T13:51:44Z Increasing cancer mortality among opioid-dependent persons in Australia: A new public health challenge for a disadvantaged population Randall, D. Degenhardt, L. Vajdic, C. Burns, L. Hall, W. Law, M. Butler, Tony Objective: To examine cancer mortality in a population-based cohort of opioiddependent 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). Sitespecifc SMRs were signifcantly 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 signifcantly 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-specifc 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. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia. 2011 Journal Article http://hdl.handle.net/20.500.11937/22390 10.1111/j.1753-6405.2011.00682.x unknown
spellingShingle Randall, D.
Degenhardt, L.
Vajdic, C.
Burns, L.
Hall, W.
Law, M.
Butler, Tony
Increasing cancer mortality among opioid-dependent persons in Australia: A new public health challenge for a disadvantaged population
title Increasing cancer mortality among opioid-dependent persons in Australia: A new public health challenge for a disadvantaged population
title_full Increasing cancer mortality among opioid-dependent persons in Australia: A new public health challenge for a disadvantaged population
title_fullStr Increasing cancer mortality among opioid-dependent persons in Australia: A new public health challenge for a disadvantaged population
title_full_unstemmed Increasing cancer mortality among opioid-dependent persons in Australia: A new public health challenge for a disadvantaged population
title_short Increasing cancer mortality among opioid-dependent persons in Australia: A new public health challenge for a disadvantaged population
title_sort increasing cancer mortality among opioid-dependent persons in australia: a new public health challenge for a disadvantaged population
url http://hdl.handle.net/20.500.11937/22390