Regional and temporal variation in receipt of long‐term opioid therapy among older breast, colorectal, lung, and prostate cancer survivors in the United States

BACKGROUND: Older cancer survivors have high rates of long‐term opioid therapy (≥90 days/year). However, the geographical and temporal variation in long‐term opioid therapy rates for older cancer survivors is not known. METHODS: A retrospective cohort study was conducted using SEER‐Medicare data. Persons aged ≥66 years, diagnosed with breast, colorectal, lung, or prostate cancer from 1991 to 2011, and alive ≥5 years after diagnosis were included. Persons were followed from 1/1/2008 until 12/31/2016. Persons were assigned to a census region in their state of residence each year. Individuals who were covered by an opioid prescription for at least 90 days in a calendar year were classified as having received long‐term opioid therapy. Multivariable analysis was conducted using generalized estimating equations. RESULTS: Temporal trends significantly varied by region (p < 0.0001) and opioid‐naïve status (p < 0.0001). Compared to 2013, opioid‐naïve cancer survivors in the south and non‐naïve survivors in the south and west experienced significant declines in long‐term opioid therapy in 2015 and 2016. Significant declines were observed in 2016 for opioid‐naïve and non‐naïve cancer survivors residing in the northeast and among opioid‐naïve cancer survivors living in the Midwest. CONCLUSION: The annual trends in the receipt of long‐term opioid therapy significantly varied by region among older cancer survivors. Variation in a clinical practice suggests the need for more research and interventions to improve efficiency, process, cost, and quality of care.