Patterns and Frequency of Opioid Use Among Individuals With a History of Gastrointestinal Malignancy: A Cross-Sectional Analysis of the 2019-2020 National Health Interview Survey (NHIS).

Background Pain is a common symptom among individuals with gastrointestinal (GI) malignancies; yet, opioid use patterns and frequency remain understudied. Our study aims to characterize the frequency and patterns of opioid use among individuals with a history of GI malignancy diagnoses. Methods This study is a retrospective analysis of cross-sectional data from the 2019 and 2020 National Health Interview Survey (NHIS). A total of 594 adults with a previous diagnosis of GI cancer, namely, esophageal, stomach, pancreatic, liver, gallbladder, or colorectal cancers, were identified. Of these, 536 reported prescription medication use in the past 12 months and constituted the analytic population for opioid-use outcomes. Multivariate regression analysis with adjustment for sociodemographic and clinical covariates was used to identify factors associated with opioid use within the GI cancer cohort. As a secondary exploratory analysis using a different reference population (absence of each cancer type in the full cancer-history sample), we compared opioid use across all reported malignancy subtypes. Results Opioid use was reported by 143 out of the 536 respondents with a history of GI malignancy, who used prescription medications (26.67%), were younger (66.44 vs. 73.31 years, p<0.001), and were more likely to be smokers (87 (60.8%) vs. 193 (49.1%), p=0.02) compared with non-users. Among chronic users, 37 (46.6%) individuals reported daily use of opioids. Those with liver cancer and esophageal cancer had the highest rates of opioid use in the past 12 months (42.8% and 39.9%) and the lowest with colorectal malignancy (20.7%). Younger age and smoking history were independently associated with opioid use (adjusted odds ratio (aOR) 0.95 and aOR 1.61, respectively). Liver cancer (aOR 0.42) and colorectal cancer (aOR 0.52) were associated with lower odds of opioid use relative to other GI malignancy subtypes. In a separate exploratory model comparing opioid use across all reported cancer diagnoses, liver and esophageal cancers showed the strongest associations with opioid use (aOR 3.10 and aOR 2.85, respectively). Conclusion Opioid use is prevalent among GI cancer survivors and varies by malignancy subtype, with individuals diagnosed with esophageal and liver cancer showing the strongest association with opioid use, supporting consideration of cancer subtype-specific pain management strategies.