Trends in Prevalence and Correlates of Alcohol Use Disorder Diagnoses Among US Adult Cancer Survivors: Serial Cross-Sectional Analysis.

BACKGROUND

Alcohol use disorder (AUD) is associated with cancer recurrence, new malignancies, and mortality among survivors of certain cancers. This study evaluated trends (2012-2021) in prevalence and correlates of AUD diagnoses among adult cancer survivors in the United States.

METHODS

This retrospective, serial cross-sectional study used claims data (2011-2021) from a national sample of US individuals with employer-sponsored health insurance. Adults diagnosed with malignant neoplasms who had at least 6 months of continuous health insurance enrollment prior to their cancer diagnosis were included. The primary outcome was a recent AUD diagnosis in each year of the study period identified from inpatient and outpatient records. We assessed AUD prevalence for each year among all cancer survivors and in specific subgroups. Using data from 2021, we compared sociodemographic and clinical characteristics between cancer survivors with and without AUD diagnoses and identified correlates of AUD diagnosis by using multivariable logistic regression.

RESULTS

Of 5,956,137 eligible cancer survivors, 105,778 (1.78%) had received an AUD diagnosis. The annual prevalence of AUD diagnoses increased from 0.78% in 2012 to 1.43% in 2021 (P<.0001). AUD prevalence also increased in specific subgroups, including individuals with alcohol-related cancers (from 0.88% to 1.61%; P<.0001) and those receiving antineoplastic agents (from 0.97% to 1.60%; P<.0001). Multivariable logistic regression analysis demonstrated that male sex, alcohol-related cancers, mental health diagnoses, and other substance use disorders were associated with at least 2 to 5 times greater odds of an AUD diagnosis.

CONCLUSIONS

AUD diagnosis among US cancer survivors with private health insurance has increased over time, mirroring trends in the general population. Integrating AUD screening and treatment into cancer care may help mitigate the unique risks associated with alcohol use and misuse in cancer survivors.