Trends in Prevalence and Correlates of Alcohol Use Disorder Diagnoses Among US Adult Cancer Survivors: Serial Cross-Sectional Analysis
Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX
Search for other papers by Anton L.V. Avanceña in
Current site
Google Scholar
PubMed
Search for other papers by Jyun-Heng Lai in
Current site
Google Scholar
PubMed
Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, TX
Department of Psychiatry & Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX
Search for other papers by Mary M. Velasquez in
Current site
Google Scholar
PubMed
Now with Department of Biostatistics, School of Public Health, Brown University, Providence, RI
Search for other papers by Corwin M. Zigler in
Current site
Google Scholar
PubMed
Pharmacotherapy Education and Research Center, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX
Search for other papers by Christopher R. Frei in
Current site
Google Scholar
PubMed
Duke Margolis Center for Health Policy, Duke University, Durham, NC
Duke Cancer Institute, Duke University, Durham, NC
Search for other papers by Michael Pignone in
Current site
Google Scholar
PubMed
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.
Submitted July 26, 2024; final revision received November 11, 2024; accepted for publication January 13, 2025.
Author contributions: Concept & design: Avanceña, Lai, Pignone. Acquisition, analysis, or interpretation of data: All authors. Statistical analysis: Avanceña, Lai, Zigler. Funding acquisition: Avanceña. Administrative, technical, or material support: Avanceña, Lai, Pignone. Supervision: Velasquez, Zigler, Frei, Pignone. Writing—original draft: Avanceña, Lai. Writing—review & editing: All authors.
Disclosures: Dr. Frei has disclosed receiving grant/research support from AstraZeneca Pharmaceuticals and Amgen (formerly Horizon) Pharmaceuticals. The remaining authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.
Funding: Dr. Avanceña was supported by a Translational Science Mentored Research Career Development (K12) Award funded by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) (K12TR004529). Dr. Frei was partially supported by NCATS/NIH through grant UM1TR004538. Dr. Pignone was supported by an American Cancer Society Clinical Research Professorship.
Disclaimer: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.
Supplementary material: Supplementary material associated with this article is available online at https://doi.org/10.6004/jnccn.2025.7007. The supplementary material has been supplied by the author(s) and appears in its originally submitted form. It has not been edited or vetted by JNCCN. All contents and opinions are solely those of the author. Any comments or questions related to the supplementary materials should be directed to the corresponding author.
Supplementary Materials
- Supplemental Materials (PDF 978 KB)
© 2019-2024 National Comprehensive Cancer Network