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Drug use disorder and risk of incident and fatal breast cancer : a nationwide epidemiological study

Dahlman, Disa LU ; Magnusson, Hedvig ; Li, Xinjun LU ; Sundquist, Jan LU and Sundquist, Kristina LU (2021) In Breast Cancer Research and Treatment 186(1). p.199-207
Abstract

Purpose: Breast cancer is one of the most common cancer forms in women and it is often detected by screening. However, women with drug use disorders (DUD) are less likely to be reached by screening programs. In this study, we aimed to investigate breast cancer incidence, mortality and stage at time of diagnosis among women with DUD compared to the general female population in Sweden. Methods: We performed a follow-up study based on Swedish national register data for the period January 1997–December 2015. The study was based on 3,838,248 women aged 15–75 years, of whom 50,858 were registered with DUD. Adjusted hazard ratios (HRs) for incident and fatal breast cancer, and cancer stage at time of diagnosis, were calculated for women with... (More)

Purpose: Breast cancer is one of the most common cancer forms in women and it is often detected by screening. However, women with drug use disorders (DUD) are less likely to be reached by screening programs. In this study, we aimed to investigate breast cancer incidence, mortality and stage at time of diagnosis among women with DUD compared to the general female population in Sweden. Methods: We performed a follow-up study based on Swedish national register data for the period January 1997–December 2015. The study was based on 3,838,248 women aged 15–75 years, of whom 50,858 were registered with DUD. Adjusted hazard ratios (HRs) for incident and fatal breast cancer, and cancer stage at time of diagnosis, were calculated for women with and without DUD using Cox regression analysis. Results: DUD was associated with incident breast cancer (HR 1.08, 95% confidence interval [CI] 1.02–1.14, p = 0.0069), fatal breast cancer (HR 1.60, 95% CI 1.42–1.82, p < 0.001), and stage IV breast cancer, i.e. metastasis at diagnosis (HR 2.06, 95% CI 1.44–2.95, p < 0.001). Conclusions: Women with DUD were identified as a risk group for incident, fatal and metastasized breast cancer, which calls for attention from clinicians and policy makers. Cancer screening attendance and other healthcare seeking barriers are likely to affect the risk increase among women who use drugs; however, more research is needed on the underlying mechanisms.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast cancer, Drug abuse, Mortality, Sweden
in
Breast Cancer Research and Treatment
volume
186
issue
1
pages
199 - 207
publisher
Springer
external identifiers
  • pmid:33156489
  • scopus:85095714119
ISSN
0167-6806
DOI
10.1007/s10549-020-05998-4
language
English
LU publication?
yes
id
ef7fef6e-7181-4590-884f-b7ba0fd17d8f
date added to LUP
2020-11-26 13:12:09
date last changed
2024-04-17 19:37:51
@article{ef7fef6e-7181-4590-884f-b7ba0fd17d8f,
  abstract     = {{<p>Purpose: Breast cancer is one of the most common cancer forms in women and it is often detected by screening. However, women with drug use disorders (DUD) are less likely to be reached by screening programs. In this study, we aimed to investigate breast cancer incidence, mortality and stage at time of diagnosis among women with DUD compared to the general female population in Sweden. Methods: We performed a follow-up study based on Swedish national register data for the period January 1997–December 2015. The study was based on 3,838,248 women aged 15–75 years, of whom 50,858 were registered with DUD. Adjusted hazard ratios (HRs) for incident and fatal breast cancer, and cancer stage at time of diagnosis, were calculated for women with and without DUD using Cox regression analysis. Results: DUD was associated with incident breast cancer (HR 1.08, 95% confidence interval [CI] 1.02–1.14, p = 0.0069), fatal breast cancer (HR 1.60, 95% CI 1.42–1.82, p &lt; 0.001), and stage IV breast cancer, i.e. metastasis at diagnosis (HR 2.06, 95% CI 1.44–2.95, p &lt; 0.001). Conclusions: Women with DUD were identified as a risk group for incident, fatal and metastasized breast cancer, which calls for attention from clinicians and policy makers. Cancer screening attendance and other healthcare seeking barriers are likely to affect the risk increase among women who use drugs; however, more research is needed on the underlying mechanisms.</p>}},
  author       = {{Dahlman, Disa and Magnusson, Hedvig and Li, Xinjun and Sundquist, Jan and Sundquist, Kristina}},
  issn         = {{0167-6806}},
  keywords     = {{Breast cancer; Drug abuse; Mortality; Sweden}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{199--207}},
  publisher    = {{Springer}},
  series       = {{Breast Cancer Research and Treatment}},
  title        = {{Drug use disorder and risk of incident and fatal breast cancer : a nationwide epidemiological study}},
  url          = {{http://dx.doi.org/10.1007/s10549-020-05998-4}},
  doi          = {{10.1007/s10549-020-05998-4}},
  volume       = {{186}},
  year         = {{2021}},
}