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    Increasing cancer mortality among opioid-dependent persons in Australia: A new public health challenge for a disadvantaged population

    Access Status
    Open access via publisher
    Authors
    Randall, D.
    Degenhardt, L.
    Vajdic, C.
    Burns, L.
    Hall, W.
    Law, M.
    Butler, Tony
    Date
    2011
    Type
    Journal Article
    
    Metadata
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    Citation
    Randall, D. and Degenhardt, L. and Vajdic, C. and Burns, L. and Hall, W. and Law, M. and Butler, T. 2011. Increasing cancer mortality among opioid-dependent persons in Australia: A new public health challenge for a disadvantaged population. Australian and New Zealand Journal of Public Health. 35 (3): pp. 220-225.
    Source Title
    Australian and New Zealand Journal of Public Health
    DOI
    10.1111/j.1753-6405.2011.00682.x
    ISSN
    1326-0200
    School
    National Drug Research Institute (NDRI)
    URI
    http://hdl.handle.net/20.500.11937/22390
    Collection
    • Curtin Research Publications
    Abstract

    Objective: To examine cancer mortality in a population-based cohort of opioiddependent persons. Methods: New South Wales opioid substitution therapy (OST) program registrants from 1985 to 2005 (n=43,789) were probabilistically linked to the National Death Index. Crude and standardised mortality rates and standardised mortality ratios (SMRs) were calculated. Results: The crude cancer mortality rate increased from 4 to 65 deaths per 100,000 person-years (p trend <0.001). Overall, OST registrants were 1.7 times more likely to die of cancer than the general population (SMR 95% CI 1.4-1.9). Sitespecifc SMRs were signifcantly elevated for lung cancer (3.6, 95% CI 2.8-4.6), liver cancer (6.9, 95% CI 4.3-10.5), and anogenital cancers (2.8, 95% CI 1.3-5.3), and signifcantly reduced for breast cancer (0.4, 95% CI 0.1-0.9). Conclusions: Cancer is an increasingly important cause of death among OST registrants as they live longer with their dependency. The site-specifc excess deaths suggest the role of tobacco, alcohol, and infection with hepatitis C and human papillomavirus. Implications: The OST setting may be a useful setting for the delivery of programs aimed at detection of precursor lesions, reducing exposure to established carcinogens, and treatment for those with HCV infection. Such targeted steps are likely to reduce the future cancer burden in this population. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

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