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Background Evidence is emerging for a role of opiates in various cancers. In this study, we aimed to investigate the association between regular opium use and cancer incidence. MethodsThis study was done in a population-based cohort of 50 045 individuals aged 40-75 years from northeast Iran. Data on participant demographics, diet, lifestyle, opium use, and different exposures were collected upon enrolment using validated questionnaires. We used proportional hazards regression models to estimate hazard ratios (HRs) and corresponding 95% CIs for the association between opium use and different cancer types. Findings During a median 10 years of follow-up, 1833 participants were diagnosed with cancer. Use of opium was associated with an increased risk of developing all cancers combined (HR 1•40, 95% CI 1•24-1•58), gastrointestinal cancers (1•31, 1•11-1•55), and respiratory cancers (2•28, 1•58-3•30) in a dose-dependent manner (p trend <0•001). For site-specific cancers, use of opium was associated with an increased risk of developing oesophageal (1•38, 1•06-1•80), gastric (1•36, 1•03-1•79), lung (2•21, 1•44-3•39), bladder (2•86, 1•47-5•55), and laryngeal (2•53, 1•21-5•29) cancers in a dose-dependent manner (p trend <0•05). Only high-dose opium use was associated with pancreatic cancer (2•66, 1•23-5•74). Ingestion of opium (but not smoking opium) was associated with brain (2•15, 1•00-4•63) and liver (2•46, 1•23-4•95) cancers in a dose-dependent manner (p rend <0•01). We observed consistent associations among ever and never tobacco users, men and women, and individuals with lower and higher socioeconomic status. Interpretation Opium users have a significantly higher risk of developing cancers in different organs of the respiratory, digestive, and urinary systems and the CNS. The results of this analysis show that regular use of opiates might increase the risk of a range of cancer types.

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BACKGROUND: Three billion people burn nonclean fuels for household purposes. Limited evidence suggests a link between household fuel use and gastrointestinal (GI) cancers. OBJECTIVES: We investigated the relationship between indoor burning of biomass, kerosene, and natural gas with the subsequent risk of GI cancers. METHODS: During the period 2004-2008, a total of 50,045 Iranian individuals 40-75 years of age were recruited to this prospective population-based cohort. Upon enrollment, validated data were collected on demographics, lifestyle, and exposures, including detailed data on lifetime household use of different fuels and stoves. The participants were followed through August 2018 with <1% loss. RESULTS: During the follow-up, 962 participants developed GI cancers. In comparison with using predominantly gas in the recent 20-y period, using predominantly biomass was associated with higher risks of esophageal [

Introduction: Breast cancer is the most frequent cancer among women worldwide. Breast cancer incidence in young women is a health issue of concern, especially in middle-income countries such as Iran. The aim of this study is to report the breast cancer incidence variations in Golestan province, Iran, over a 10-year period (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013). Methods: We analyzed data from the Golestan Population-based Cancer Registry (GPCR), which is a high-quality cancer registry collecting data on primary cancers based on standard protocols throughout the Golestan province. Age-standardized incidence rates (ASRs) and age-specific incidence rates per 100,000 person-years were calculated. Time trends in ASRs and age-specific rates were evaluated using Joinpoint regressions. The average annual percentage change (AAPC) with correspondence 95% confidence intervals (95%CIs) were calculated. Results: A total of 2106 new breast cancer cases were diagnosed during the study period. Most cases occurred in women living in urban areas: 1449 cases (68%) versus 657 cases (31%) in rural areas. Statistically significant increasing trends were observed over the 10-year study period amongst women of all ages (AAPC = 4.4; 95%CI: 1.2-7.8) as well as amongst women in the age groups 20-29 years (AAPC = 10.0; 95%CI: 1.7-19.0) and 30-39 years (AAPC = 5.1; 95%CI: 1.4-9.0). Conclusion:The incidence of breast cancer increased between 2004 and 2013 in Golestan province amongst all age groups, and in particular amongst women aged 20-39 years. Breast cancer should be considered a high priority for health policy making in our community.The incident rate of breast cancer is 46.3 per 100,000 worldwide [2], and the total number of breast cancer cases is predicted to increase in the future, reaching 3 million in 2030 [2,3].Incidence rates are higher in high-income countries: North America, Western Europe and Oceania, as compared with Africa, South America and Asia [2]. The breast cancer screening program, as well as a higher prevalence of risk factors, explain the higher incidence in these

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