Opioid prescription and usage disparities among Puerto Rican breast cancer survivors: findings from the Puerto Rico central cancer registry-health insurance linkage database (PRCCR-HILD).

PURPOSE: Hispanic/Latina breast cancer patients receive fewer opioid prescriptions for cancer-related pain. The primary aim of this study was to explore opioid prescription rates among Hispanic/Latina breast cancer survivors living in Puerto Rico.

METHODS

This cross-sectional study analyzed opioid prescription use in a retrospective cohort of Puerto Rican breast cancer women using the Puerto Rico Central Cancer Registry-Health Insurance Linkage Database. Adjusted odds ratios and incidence rate ratios with 95% confidence intervals were estimated using logistic and negative binomial regression analyses to assess factors associated with the use and frequency of opioids use.

RESULTS

Puerto Rican breast cancer survivors, mostly 40-64 years old were included (n = 1,733). Opioid prescription three years following their breast cancer diagnosis was 13.1%. Participants enrolled in Medicare (AOR = 9.77) and dually eligible for Medicare-Medicaid (AOR = 5.54), with a comorbidity index of 1 (AOR = 1.50), with a history of opioid use before their cancer diagnosis (AOR = 2.49), and that received chemotherapy (AOR = 1.47) were more likely to be prescribed opioids. Analyses in rates of opioid prescription revealed statistically significant increases among those enrolled in Medicare (IRR = 17.51) and dually eligible for Medicare-Medicaid (IRR = 11.74) and for those with a history of opioid prescription before diagnosis (IRR = 4.16).

CONCLUSION

Future research should explore how factors such as structural racism and geographic isolation shape opioid prescription and usage among breast cancer survivors living in Puerto Rico.