Mortality and Cause of Death—A 30-Year Follow-Up of Substance Misusers in Sweden

Greiff, Ninive von; Skogens, Lisa; Berlin, Marie; Bergmark, Åke

doi:10.1080/10826084.2018.1452261

Cited by 17 publications

(19 citation statements)

References 27 publications

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“…The majority of the clients in the present study who gave alcohol as their most dominant form of substance misuse were polydrug users (von Greiff et al 2018). Both gender groups that reported alcohol as their most dominant form of substance misuse showed a higher mortality risk compared with those with stimulants as their main form of substance misuse.…”

Section: Gender Differences and Similarities Regarding Predictors Of mentioning

confidence: 57%

“…In the 1980s, when the data were collected, inpatient treatment units in Sweden were not specialized according to substance misuse, but instead admitted and mixed all types of clients. A 30year follow-up investigating standardized mortality rates (SMR) in the SWEDATE group and identifying the cause of death in different groups based on type of misuse (von Greiff et al 2018) showed gender differences. The largest differences were found in the groups whose self-reported dominant substance misuse was cannabis (4.3 for women versus 9.9 for men) and opiates (13.5 for women versus 18.3 for men).…”

Section: The Swedate Projectmentioning

confidence: 99%

“…The variable Misuse in last 12 months before intake was created as five mutually exclusive categories: Alcohol, Cannabis, Stimulants, Opiates and Other, based on what the interviewees had told the interviewer was the most dominant misuse substance for that period (for more details on the categories, see von Greiff et al 2018).…”

Section: Background Variablesmentioning

confidence: 99%

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A 30-year follow-up of substance misusers in Sweden – differences in predictors of mortality between women and men

Skogens

Greiff

Berlin

et al. 2019

Addiction Research & Theory

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Background: Differing results on gender specific factors related to mortality risks among substance misusers highlights the need for further research. The present article is based on a 30-year follow-up study on substance misusers treated in residential care for drug problems in Sweden in 1982-1983 aiming to identify and compare gender differences in predictors of mortality. Method: Original data consists of personal interviews with 1163 substance misusers treated in inpatient units in Sweden during 1982Sweden during -1983. The outcome variable is death retrieved from the National Cause of Death Register held by the National Board of Health and Welfare. Gender differences and similarities regarding predictors of mortality was estimated in univariate and multivariate models, using Cox proportional hazards models. Results: School failure, imprisonment and being a parent without custody of the child seem to constitute risk factors for mortality among women, but not among men. A social network of friends seemed to be more important for men. Treatment-dropout was a significant risk factor for premature death among men, but not among women. Both gender reporting alcohol as their self-reported most dominant substance misuse showed higher mortality risks compared with those with stimulants as dominant substance misuse. Conclusions: Imprisonment was highly predictive of mortality for the women, suggesting that this group is important to pay particular attention to. Suggested differences in the importance of social factors need to be investigated more thoroughly. The substantial hazard revealed for women with polydrug misuse including alcohol calls for attention to this in treatment for substance misuse. ARTICLE HISTORY

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Section: Gender Differences and Similarities Regarding Predictors Of mentioning

confidence: 57%

Section: The Swedate Projectmentioning

confidence: 99%

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A 30-year follow-up of substance misusers in Sweden – differences in predictors of mortality between women and men

Skogens

Greiff

Berlin

et al. 2019

Addiction Research & Theory

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“…We conducted an additional analysis on opioid use disorder as the independent variable, and found no significant association with incident breast cancer or fatal breast cancer. As opioid dependence is associated with significantly increased mortality due to both drug-related (mainly overdose) and non-drug-related causes of death [1][2][3], it is possible that fatalities due to other causes than breast cancer might explain the results from Randall et al [4].…”

Section: Discussionmentioning

confidence: 99%

“…Drug use disorders (DUD) are associated with a range of adverse health outcomes including increased mortality rates [1,2]. For example, patients in opioid substitution treatment (OST) are shown to have significantly higher non-drugrelated mortality, including in cancer, than the general population [3,4].…”

Section: Introductionmentioning

confidence: 99%

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

Dahlman

Magnusson

et al. 2020

Breast Cancer Res Treat

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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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Drug use disorder and risk of incident and fatal prostate cancer among Swedish men: a nationwide epidemiological study

Dahlman

Crump

et al. 2021

Cancer Causes Control

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Purpose Prostate cancer is the second most common cancer in men and a leading cause of cancer mortality worldwide. Men with drug use disorders (DUD) may potentially be at high risk for prostate cancer mortality because of delayed diagnosis and/or undertreatment. In this study, we aimed to investigate prostate cancer incidence, mortality, and stage at time of diagnosis among men with DUD compared to the general male population in Sweden. Methods We performed a follow-up study based on Swedish national register data for the period January 1997–December 2016. The study was based on 1,361,532 men aged 50–75 years at inclusion, of whom 9,259 were registered with DUD. Cox regression analysis was used to compute adjusted hazard ratios (HRs) for incident and fatal prostate cancer, and cancer stage at time of diagnosis, associated with DUD. Results DUD was associated with a slightly increased risk of incident prostate cancer (HR: 1.07, 95% confidence interval [CI] 1.00–1.14, p = 0.048) and substantially higher risk of fatal prostate cancer (HR: 1.59, 95% CI 1.40–1.82, p < 0.001), adjusted for age, socioeconomic factors, and comorbidities related to tobacco smoking and alcohol use disorder. No association was found between DUD and prostate cancer stage at diagnosis. Conclusions Men with DUD have an increased risk of fatal prostate cancer, possibly related to undertreatment in this patient population. Our findings should raise attention among medical staff and decision-makers towards a disadvantaged group of men in need of easily accessible prostate cancer evaluation and treatment.

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Mortality and Cause of Death—A 30-Year Follow-Up of Substance Misusers in Sweden

Cited by 17 publications

References 27 publications

A 30-year follow-up of substance misusers in Sweden – differences in predictors of mortality between women and men

A 30-year follow-up of substance misusers in Sweden – differences in predictors of mortality between women and men

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

Drug use disorder and risk of incident and fatal prostate cancer among Swedish men: a nationwide epidemiological study

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