Opium Could Be Considered an Independent Risk Factor for Lung Cancer: A Case-Control Study

Masjedi, Mohammad Reza; Naghan, Parisa Adimi; Taslimi, Shervin; Yousefifard, Mahmoud; Ebrahimi, Seyyed Meisam; Khosravi, Adnan; Karimi, Shirin; Hosseini, Mostafa; Mortaz, Esmaeil

doi:10.1159/000338559

Cited by 49 publications

(73 citation statements)

References 46 publications

(25 reference statements)

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“…The two previous epidemiological studies of opium in relation to laryngeal cancer7 8 had a retrospective case-control design and showed statistically significant increased risks, with ORs close to 10. Previous studies9 10 have also shown an increased risk of lung cancer, with relative risks of close to 2 or 3 in opium users. Our study results did not show statistically significant increased risks of lung cancer or laryngeal cancer in opium users, but the point estimates of the HRs were above 1 and consistent with the findings of the previous studies.…”

Section: Discussionmentioning

confidence: 89%

“…Whereas a few other studies evaluating the carcinogenicity of opium appeared in the literature in the 1970s and early 1980s, there was a hiatus for nearly two decades, and most studies of opium and cancer have been published in the last 12 years 15. Epidemiological studies have associated opium use with increased risk of cancers of the oral cavity,14 16 larynx,7 8 lung,9 10 oesophagus,17–20 stomach20–23 and bladder 24–29. The two previous epidemiological studies of opium in relation to laryngeal cancer7 8 had a retrospective case-control design and showed statistically significant increased risks, with ORs close to 10.…”

Section: Discussionmentioning

confidence: 99%

“…However, these clinical studies were limited by small sample sizes, lack of control groups and possible confounding by cigarette smoking and other factors. More recently, epidemiological studies of laryngeal cancer,7 8 and lung cancer9 10 in relation to opium use have been conducted, which have controlled for smoking. However, these studies have had retrospective case-control designs, which may be subject to control selection bias, recall bias and interviewer bias.…”

Section: Introductionmentioning

confidence: 99%

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Mortality from respiratory diseases associated with opium use: a population-based cohort study

Rahmati

Shakeri

Khademi

et al. 2016

Thorax

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Background Recent studies have suggested that opium use may increase mortality from cancer and cardiovascular diseases. However, no comprehensive study of opium use and mortality from respiratory diseases has been published. We aimed to study the association between opium use and mortality from respiratory disease using prospectively collected data. Methods We used data from the Golestan Cohort Study (GCS), a prospective cohort study in northeastern Iran, with detailed, validated data on opium use and several other exposures. A total of 50,045 adults were enrolled from 2004 to 2008, and followed annually until June 2015, with a follow-up success rate of 99%. We used Cox proportional hazard regression models to evaluate the association between opium use and outcomes of interest. Results During the follow-up period 331 deaths from respiratory disease were reported (85 due to respiratory malignancies and 246 due to nonmalignant etiologies). Opium use was associated with an increased risk of death from any respiratory disease (adjusted hazard ratio (HR) 95% CI; 3.13 (2.42-4.04)). The association was dose-dependent with a HR of 3.84 (2.61-5.67) for the highest quintile of cumulative opium use vs. never use (Ptrend<0.001). The hazard ratios (95% CI) for the associations between opium use and malignant and nonmalignant causes of respiratory mortality were 1.96 (1.18-3.25) and 3.71 (2.76-4.96), respectively. Conclusion Long-term opium use is associated with increased mortality from both malignant and nonmalignant respiratory diseases.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mortality from respiratory diseases associated with opium use: a population-based cohort study

Rahmati

Shakeri

Khademi

et al. 2016

Thorax

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“…Regular use of opium has been reported to be associated with increased risk of several cancers, including esophageal cancer 9-11 , laryngeal cancer 12 , bladder cancer 13-15 , and lung cancer 16 , but to our knowledge no epidemiologic studies of opium use and gastric cancer have been published. About 0.3-0.5% of the world’s population in the 15-64 year old age group, between 12 and 21 million people, used opiates at least once in 2009 17 .…”

Section: Introductionmentioning

confidence: 96%

Opium: An emerging risk factor for gastric adenocarcinoma

Shakeri

Malekzadeh

Etemadi

et al. 2013

Intl Journal of Cancer

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Opium use has been associated with higher risk of cancers of the esophagus, bladder, larynx, and lung; however, no previous study has examined its association with gastric cancer. There is also little information on the associations between hookah (water pipe) smoking or the chewing of tobacco products and the risk of gastric cancer. In a case-control study in Golestan Province of Iran, we enrolled 309 cases of gastric adenocarcinoma (118 noncardia, 161 cardia, and 30 mixed-location adenocarcinomas) and 613 matched controls. Detailed information on long-term use of opium, tobacco products, and other covariates were collected using structured and validated lifestyle and food frequency questionnaires. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were obtained using conditional logistic regression models. Opium use was associated with an increased risk of gastric adenocarcinoma, with an adjusted OR (95% CI) of 3.1 (1.9 – 5.1), and this increased risk was apparent for both anatomic subsites (cardia and noncardia). There was a dose-response effect, and individuals with the highest cumulative opium use had the strongest association (OR: 4.5; 95%CI: 2.3-8.5). We did not find a statistically significant association between the use of any of the tobacco products and risk of gastric adenocarcinoma, overall or by anatomic subsite. We showed, for the first time, an association between opium use and gastric adenocarcinoma. Given that opium use is a traditional practice in many parts of the world, these results are of public health significance.

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“…Use of opium and its derivatives has also been questioned as a factor (22). However, it has been proved as a risk factor for various cancers such as gastric (23,24), lung (25), larynx (26), bladder (27), and esophagus (24). Also, in a study in north of Iran, it was demonstrated that the level of morphine metabolites in the urine sample of patients in high risk regions for esophageal cancer was 6 times higher than in other regions (28).…”

Section: Introductionmentioning

confidence: 99%

Opium Use and Risk of Lower Gastrointestinal Cancers: Population-Based Case-Control Study in South of Iran

Lankarani¹,

Khosravizadegan²,

Naghibzadeh‐Tahami³

et al. 2017

Int J Cancer Manag

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Background: Colorectal cancers, including colon, rectum and anus, are relatively prevalent in Iran. Use of opium and its derivatives is also considerably prevalent in some areas in Iran. Objectives: The aim of this study was to assess the association between use of opium and its derivatives, and incidence of lower gastrointestinal (LGI) cancers. Methods: This study was a matched case-control study in Shiraz (south of Iran). Cases were the new colorectal cancers from cancer registry center of Shiraz University of Medical Sciences and controls were selected from healthy volunteers of cases' neighbors matched for age and gender (2 controls per 1 case). Data related to consumption of opium and its derivatives, smoking, alcohol use and diet status were collected through a structured questionnaire. The conditional logistic regression models were used to assess all associations. Results: 160 cases and 320 controls participated in the present study with non-response rate less than 9 %. Opium use was associated with increased risk of colorectal cancer (adjusted OR = 4.4; 95% CI: 2.2 -8.8). Also, a dose-response association was observed between cumulative consumption of opium and the colorectal cancer incidence (OR = 3.8; 95% CI: 1.5 -9.1), and (OR = 4.6; 95% CI: 1.7 -12.0) for low and high use, respectively. Also, the significant dose-response association was observed for low (OR = 3.4; 95% CI: 1.2 -9.2) and high (OR = 7.7; 95% CI: 1.5 -38.6) opium use with presence of colon cancer. Conclusions:The results of this study showed that opium use can be an important risk factor for colorectal cancer in Iran.

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Opium Could Be Considered an Independent Risk Factor for Lung Cancer: A Case-Control Study

Cited by 49 publications

References 46 publications

Mortality from respiratory diseases associated with opium use: a population-based cohort study

Mortality from respiratory diseases associated with opium use: a population-based cohort study

Opium: An emerging risk factor for gastric adenocarcinoma

Opium Use and Risk of Lower Gastrointestinal Cancers: Population-Based Case-Control Study in South of Iran

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