AbstractBackground/ObjectivesLong-term consequences of opioid consumption, such as misuse, have been a major concern in patients with chronic non-cancer pain. Potentially opioid misuse may also be a consequence in patients with cancer in opioid treatment which encouraged us to undertake this systematic review assessing the frequency of opioid misuse in this population.Materials/MethodsThe search strategy comprised words related to cancer, opioid misuse, and frequency.

摘要背景/目的阿片类药物消费的长期后果，如滥用，一直是慢性非癌症疼痛患者的主要关注点。在阿片类药物治疗中，潜在的阿片类药物滥用也可能是癌症患者的后果，这鼓励我们进行这项系统评价，评估该人群中阿片类药物滥用的频率。材料/方法搜索策略包括与癌症，阿片类药物滥用和频率相关的单词。

PubMed, Embase, PsycInfo, and Cinahl were searched from inception to July 2023. Prospective studies were selected and analysed regarding frequency, study characteristics, and quality. A meta-analysis was possible to carry out for a sub-group (opioid misuse risk).ResultsFrom 585 abstracts screened, six articles were included.

PubMed，Embase，PsycInfo和Cinahl从开始到2023年7月被搜索。选择前瞻性研究并分析频率，研究特征和质量。可以对一个亚组（阿片类药物滥用风险）进行荟萃分析。结果从585篇摘要中筛选出6篇文章。

Only prevalence data were found. The prevalence of opioid misuse ranged from 5.7% to 84%, while the prevalence of opioid misuse risk varied from 2.4% to 35.4%. The pooled prevalence of opioid misuse risk was 12.3% (95% CI: 0.8–36.3; I2 = 98.4%, 95% CI: 97.2–99.1). The studies differed regarding, e.g., methods, misuse definitions, and assessment instruments.ConclusionsFew studies were identified and large differences in prevalence for opioid misuse and opioid misuse risk were observed.

仅发现患病率数据。阿片类药物滥用的患病率从5.7%到84%不等，而阿片类药物滥用风险的患病率从2.4%到35.4%不等。阿片类药物滥用风险的汇总患病率为12.3%（95%CI:0.8-36.3；I2=98.4%，95%CI:97.2-99.1）。这些研究在方法，滥用定义和评估工具等方面存在差异。结论确定了一些研究，观察到阿片类药物滥用患病率和阿片类药物滥用风险存在较大差异。

Methodological disparities and the studies quality underscore the importance of improved studies in the future..

方法上的差异和研究质量强调了未来改进研究的重要性。。

IntroductionCancer is a complex and life-threatening disease, which according to estimates will affect 21.9 million people around the world in 2025 [1]. In patients with cancer and especially advanced disease, pain is one of the most frequent and distressing symptoms [2, 3]. It might be the result of the cancer disease itself and/or antineoplastic treatment.

引言癌症是一种复杂且威胁生命的疾病，据估计，到2025年，全球将有2190万人受到影响。在癌症患者尤其是晚期疾病患者中，疼痛是最常见和最痛苦的症状之一[2，3]。这可能是癌症疾病本身和/或抗肿瘤治疗的结果。

The clinical evidence supports the use of opioids as the gold standard in moderate to severe cancer-related pain [4]. In addition, opioids are a versatile pharmacological group with several advantages as superior efficacy, multiple routes of administration, ease of titration, no ceiling dose, among others.

临床证据支持使用阿片类药物作为中重度癌症相关疼痛的金标准（4）。此外，阿片类药物是一种多功能的药理学组，具有优越的疗效，多种给药途径，易于滴定，无上限剂量等优点。

However, in the last two decades the use of opioid treatment in chronic non-cancer pain has produced an indiscriminate escalation of prescribed opioids and misuse problems, which recently have raised concerns about potential misuse in patients with cancer, mainly due to higher survival rates.In the literature, there are many different terms with similar meanings and referring to types of opioid misuse.

然而，在过去的二十年中，在慢性非癌症疼痛中使用阿片类药物治疗导致处方阿片类药物和滥用问题的不分青红皂白地升级，这最近引起了人们对癌症患者潜在滥用的担忧，主要是由于生存率较高。在文献中，有许多含义相似的不同术语，涉及阿片类药物滥用的类型。

Examples are opioid dependence, opioid use disorder, opioid abuse, opioid addiction, opioid aberrant behaviour, non-medical opioid use, and chemical coping, among others. There are general diagnostic criteria for opioid dependence by the International Classification of Diseases—ICD 11 [5] and for opioid use disorder by Diagnostic and Statistical Manual of Mental Disorders fifth edition—DSM-5 [6], which describe behaviour, psychological aspects, and physiologic symptoms.

例子包括阿片类药物依赖，阿片类药物使用障碍，阿片类药物滥用，阿片类药物成瘾，阿片类药物异常行为，非医疗阿片类药物使用和化学应对等。。

For patients with chronic pain, there are Portenoy’s criteria for characterising opioid addiction [7] and Chabal et al.’s criteria for identifying prescription opiate abuser [8], which are based on the general criteria mentioned above and describe be.

对于慢性疼痛患者，有Portenoy的阿片类药物成瘾特征标准（7）和Chabal等人的处方阿片类药物滥用者识别标准（8），它们基于上述一般标准并描述be。

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Download referencesFundingOpen access funding provided by Copenhagen University.Author informationAuthors and AffiliationsFaculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkTazha AkoDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkMark Puch Ørnskov & Geana Paula KuritaMultidisciplinary Pain Centre, Department of Anesthesiology, Pain and Respiratory Support, Rigshospitalet Copenhagen University Hospital, Copenhagen, DenmarkMark Puch Ørnskov & Geana Paula KuritaSection of Palliative Medicine, Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, DenmarkCamilla Lykke, Per Sjøgren & Geana Paula KuritaDepartment of Oncology and Palliative Care, North Zealand Hospital, Hillerød, DenmarkCamilla LykkeAuthorsTazha AkoView author publicationsYou can also search for this author in.

下载哥本哈根大学提供的参考基金开放获取资金。作者信息作者和附属机构哥本哈根大学健康与医学科学学院，丹麦哥本哈根大学健康与医学科学学院临床医学系，丹麦哥本哈根大学，丹麦马克·普契尔恩斯科夫和吉安娜·保拉·库里塔多学科疼痛中心，哥本哈根Rigshospitalet哥本哈根大学医院麻醉学，疼痛和呼吸支持系，丹麦马克·普契尔恩斯科夫和吉安娜·保拉·库里塔姑息医学系，哥本哈根Rigshospitalet哥本哈根大学医院肿瘤学系，丹麦卡米拉·莱克，佩尔Sjøgren＆Geana Paula Kurita新西兰医院肿瘤与姑息治疗科，Hillerød，DenmarkCamilla LykkeAuthorsTazha AkoView作者出版物您也可以在中搜索这位作者。

PubMed Google ScholarMark Puch ØrnskovView author publicationsYou can also search for this author in

PubMed Google ScholarMark PuchØrnskovView作者出版物您也可以在

PubMed Google ScholarCamilla LykkeView author publicationsYou can also search for this author in

PubMed Google ScholarCamilla LykkeView作者出版物您也可以在

PubMed Google ScholarPer SjøgrenView author publicationsYou can also search for this author in

PubMed Google ScholarPer SjøgrenView作者出版物您也可以在

PubMed Google ScholarGeana Paula KuritaView author publicationsYou can also search for this author in

PubMed Google ScholarGeana Paula KuritaView作者出版物您也可以在

PubMed Google ScholarContributionsGPK and TA conceptualised the study. TA, GPK, and MPØ were involved in acquired data, interpreted the results, and reviewed literature. TA, GPK, MPØ, PS, and CL contributed to the writing, revised the manuscript, and agreed to be accountable for all aspects of the work.Corresponding authorsCorrespondence to.

PubMed谷歌学术贡献SGPK和TA将这项研究概念化。TA，GPK和MPØ参与了获取的数据，解释了结果，并回顾了文献。TA，GPK，MPØ，PS和CL为写作做出了贡献，修订了稿件，并同意对工作的各个方面负责。通讯作者通讯至。

Tazha Ako or Geana Paula Kurita.Ethics declarations

Tazha Ako或Geana Paula Kurita。道德宣言

Competing interests

相互竞争的利益

The authors declare no competing interests. GPK has received grants to other projects from Novo Nordisk Foundation, European Commission, and the Danish Cancer Society.

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Reprints and permissionsAbout this articleCite this articleAko, T., Ørnskov, M.P., Lykke, C. et al. Prevalence of opioid misuse in patients with cancer: a systematic review and meta-analysis.

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Br J Cancer (2024). https://doi.org/10.1038/s41416-024-02802-8Download citationReceived: 29 February 2024Revised: 18 June 2024Accepted: 16 July 2024Published: 26 July 2024DOI: https://doi.org/10.1038/s41416-024-02802-8Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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癌症药物调节疼痛