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Cheraghi Z, Azmi-Naei B, Azmi-Naei N, Ameri M. The significant impact of opium use on various types of cancer: an updated - systematic review and meta-analysis. BMC Cancer 2025; 25:353. [PMID: 40000967 PMCID: PMC11863765 DOI: 10.1186/s12885-025-13768-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Accepted: 02/18/2025] [Indexed: 02/27/2025] Open
Abstract
OBJECTIVE The existing literature on the direct effects of opioid use on cancer is limited. The goal of our systematic review and meta-analysis is to consolidate the findings of previous studies and provide a pooled effect size regarding the association between opioid usage and cancer. METHODS The PRISMA guidelines were employed to construct a framework for conducting this systematic review and meta-analysis. A systematic search was conducted in international and national databases. A search of PubMed, Web of Science, Scopus, and national electronic databases was conducted up to May 2024. The random effects model was employed for the presentation of results with a 95% confidence interval. The statistical analysis was conducted using Stata 11. RESULTS Out of 1674 articles were retrieved 38 studies remained in the final analysis (six cohort study and 32 case-control studies). The pooled adjusted odds ratio of opium on esophageal cancer was 1.68 (95% CI: 1.36, 2.08), for bladder cancer was 5.00(95% CI: 3.76, 6.66), for head and neck cancer was 4.93 (95% CI: 2.41, 10.06) for pancreatic cancer was 2.4 (95% CI: 1.62, 2.56) for lung cancer was 2.89(95% CI: 2.14, 3.30) for laryngeal cancer was 6.76 (95% CI: 3.77, 11.80) for gastric cancer was 3.13 (95% CI: 1.92, 5.11) and for colorectal cancer was 2.51 (95% CI: 1.04, 6.07).All association were statistically significant. CONCLUSION The findings underscore the potential carcinogenic effects of opium on cancers. Public health organizations should work collaboratively to mitigate opioid exposure while promoting alternative pain management strategies to protect community health and reduce the burden of cancer.
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Affiliation(s)
- Zahra Cheraghi
- Modeling of Noncommunicable Diseases Research Center, Institute of Health Sciences and Technologies, Hamadan University of Medical Sciences, Hamadan, 0000- 0001-9041-559X, 65157835129, Iran.
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Bita Azmi-Naei
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nazanin Azmi-Naei
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohadese Ameri
- School of Medicine, Islamic Azad university of medical science, Tehran, Iran
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Eslami H, Tohidi R, Ranjbar FE, Moetamed S, Vatanparast M. Reinke's Edema and Risk Factors, A Case-Control Study. Indian J Otolaryngol Head Neck Surg 2024; 76:1819-1824. [PMID: 38566636 PMCID: PMC10982200 DOI: 10.1007/s12070-023-04418-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 11/30/2023] [Indexed: 04/04/2024] Open
Abstract
Reinke's edema (RE) is a benign pathological non-inflammatory disorder of the vocal folds with a wide range of clinical manifestations. We aim to investigate the relationship between Reinke's edema and some common inhalant abuse. In this case-control study, subjective consisted of 23 patients with RE (the cases), and 50 patients with sinusitis (control) who underwent surgery in the Department of Otolaryngology, between 2015 and 2020. Demographic characteristics, history of some related disease, methods, and the duration of cigarette, and opium consumption were collected through the patients' files. The chi-square (χ²) test was run to analyze the differences in the categorical and, and the Independent Sample T-test was used to compare two sample means from unrelated groups. A significant level (p-value) was considered less than 0.05. The mean age was 54 ± 12 years, and 42 ± 11 years, respectively for Reinke's edema and sinusitis. More women had been recorded in the RE group, compared to men. Allergy, unprincipled use of voice and talkativeness, history of laryngeal surgery, and type of disease were correlated to RE (p < 0.05). Also, cigarette smoking was significantly correlated with Reinke's edema. The average number of cigarettes per day, the duration of smoking, and opium consumption were more frequent in RE (P < 0.05). 90% of the RE and 4% of sinusitis patients were opium consumers. There was a statistically significant difference in the methods of substance use in the two groups of cases and control (p < 0.0001). Among the different methods, the poker and stone method was the most common (69.6%), and the opium smoking pipe was the second most common method. This study also confirmed the hazardous effects of smoking and inhaling opiates in the formation of lesions of the pharynx and larynx. In particular, longer use of these substances will be associated with more serious side effects. Therefore, it seems that people who are addicted to opiates should undergo periodic visits and counseling to reduce and stop their use.
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Affiliation(s)
- Hadi Eslami
- Department of Otorhinolaryngology Head and Neck Surgery, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Reyhaneh Tohidi
- Department of Otorhinolaryngology Head and Neck Surgery, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
- Department of Ophthalmology and otorhinolaryngology, Clinical Research Development Unit (CRDU), Moradi Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Faezeh Esmaeili Ranjbar
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Soheil Moetamed
- Department of Otorhinolaryngology Head and Neck Surgery, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahboubeh Vatanparast
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Mansouri B, Azadi N, Drebadami AH, Nakhaee S. Trace element levels: How Substance Use Disorder (SUD) contributes to the alteration of urinary essential and toxic element levels. PLoS One 2024; 19:e0294740. [PMID: 38315674 PMCID: PMC10843129 DOI: 10.1371/journal.pone.0294740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 11/07/2023] [Indexed: 02/07/2024] Open
Abstract
Increasing illicit drug use is one of the main problems in most countries or societies. Monitoring heavy metals and trace elements in this vulnerable group seems to be necessary. Therefore, we assessed the urinary trace element and toxic metals/metalloids concentrations (Zinc (Zn), Iron (Fe), Copper (Cu), Chromium (Cr), Lead (Pb), Cadmium (Cd), Arsenic (As), Nickel (Ni), and Mercury (Hg)) in opium, tramadol, and cannabis users compared to healthy subjects. In this cross-sectional study, patients with substance use disorder (SUD) (n = 74) were divided into four groups: cannabis, tramadol, opium, and mixed (simultaneous use of more than one of the three studied substances), along with a healthy group (n = 60). Urine samples were prepared by dispersive liquid-liquid microextraction method so that heavy metals/metalloids could be measured by ICP-MS. The mean urinary concentration of Cu (48.15 vs. 25.45; 89.2%, p<0.001), Hg (1.3 vs. 0.10; 1200%, p < 0.001), and Zn (301.95 vs. 210; 43.8%, p < 0.001) was markedly lower among patients with SUD. The mean urinary concentration of other elements including As (1.9 vs. 4.1; 115.8%), Cd (0.1 vs. 1.10; 1000%), Cr (6.80 vs. 11.65; 71.3%), Ni (2.95 vs. 4.95; 67.8%), and Pb (1.5 vs. 7.9; 426.6%) were significantly higher among patients with SUD compared to healthy subjects. When sub-groups were compared, no significant differences were observed between their trace element levels (Kruskal-Wallis test, p > 0.05). This can be an indication that regardless of the type of drug, the levels of trace elements are changed with respect to healthy individuals. Our results showed that illicit drug use causes changes in urinary trace element/heavy metal/metalloid levels and highlights the need for monitoring heavy metals and trace elements in individuals with substance use disorder. Assessment of different elements in biological samples of drug dependents may be useful for implementing new prevention and treatment protocols. In case of changes in their levels, complementary recommendations, attention to diet, and periodic assessment of toxic metal levels within treatment programs will be needed.
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Affiliation(s)
- Borhan Mansouri
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nammamali Azadi
- Biostatistics Department, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Arezo Hashemi Drebadami
- State Welfare Organization of Kermanshah, Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah, Iran
| | - Samaneh Nakhaee
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Southern Khorasan, Iran
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Flor LS, Anderson JA, Ahmad N, Aravkin A, Carr S, Dai X, Gil GF, Hay SI, Malloy MJ, McLaughlin SA, Mullany EC, Murray CJL, O'Connell EM, Okereke C, Sorensen RJD, Whisnant J, Zheng P, Gakidou E. Health effects associated with exposure to secondhand smoke: a Burden of Proof study. Nat Med 2024; 30:149-167. [PMID: 38195750 PMCID: PMC10803272 DOI: 10.1038/s41591-023-02743-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/28/2023] [Indexed: 01/11/2024]
Abstract
Despite a gradual decline in smoking rates over time, exposure to secondhand smoke (SHS) continues to cause harm to nonsmokers, who are disproportionately children and women living in low- and middle-income countries. We comprehensively reviewed the literature published by July 2022 concerning the adverse impacts of SHS exposure on nine health outcomes. Following, we quantified each exposure-response association accounting for various sources of uncertainty and evaluated the strength of the evidence supporting our analyses using the Burden of Proof Risk Function methodology. We found all nine health outcomes to be associated with SHS exposure. We conservatively estimated that SHS increases the risk of ischemic heart disease, stroke, type 2 diabetes and lung cancer by at least around 8%, 5%, 1% and 1%, respectively, with the evidence supporting these harmful associations rated as weak (two stars). The evidence supporting the harmful associations between SHS and otitis media, asthma, lower respiratory infections, breast cancer and chronic obstructive pulmonary disease was weaker (one star). Despite the weak underlying evidence for these associations, our results reinforce the harmful effects of SHS on health and the need to prioritize advancing efforts to reduce active and passive smoking through a combination of public health policies and education initiatives.
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Affiliation(s)
- Luisa S Flor
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
| | - Jason A Anderson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Noah Ahmad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Aleksandr Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Sinclair Carr
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Gabriela F Gil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Matthew J Malloy
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Susan A McLaughlin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin C Mullany
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Erin M O'Connell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Chukwuma Okereke
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Reed J D Sorensen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Joanna Whisnant
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Zhang M, Hashibe M, Rao JY, Jung SY, Tashkin DP, Morgenstern H, Zhang ZF. Opium, phencyclidine, and crack cocaine smoking associations with lung and upper aerodigestive tract cancers: exploratory findings from a case-control study in Los Angeles County. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:440-449. [PMID: 37433108 PMCID: PMC10540566 DOI: 10.1080/00952990.2023.2220875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/18/2023] [Accepted: 05/28/2023] [Indexed: 07/13/2023]
Abstract
Background: Illicit drug use has become a global epidemic, yet it is unclear if drug smoking increases the risk of tobacco-related cancers.Objectives: We aimed to evaluate hypothesized associations between smoking three drugs - opium, phencyclidine (PCP) and crack cocaine and lung and upper aerodigestive tract (UADT) cancers.Methods: A population-based case-control study with 611 lung cancer cases (50% male), 601 UADT cancers cases (76% male), and 1,040 controls (60% male) was conducted in Los Angeles County (1999-2004). Epidemiologic data including drug smoking histories were collected in face-to-face interviews. Associations were estimated with logistic regressions.Results: Adjusting for potential confounders, ever vs. never crack smoking was positively associated with UADT cancers (aOR = 1.56, 95% CI: 1.05, 2.33), and a dose-response relationship was observed for lifetime smoking frequency (p for trend = .024). Heavy (> median) vs. never crack smoking was associated with UADT cancers (aOR = 1.81, 95% CI: 1.07, 3.08) and lung cancer (aOR = 1.58, 95% CI: 0.88, 2.83). A positive association was also observed between heavy PCP smoking and UADT cancers (aOR = 2.29, 95% CI: 0.91, 5.79). Little or no associations were found between opium smoking and lung cancer or UADT cancers.Conclusion: The positive associations between illicit drug use and lung and/or UADT cancers suggest that smoking these drugs may increase the risk of tobacco-related cancers. Despite the low frequency of drug smoking and possible residual confounding, our findings may provide additional insights on the development of lung and UADT cancers.
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Affiliation(s)
- Mingyan Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Jian-Yu Rao
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Su Yon Jung
- Translational Sciences Section, UCLA Jonsson Comprehensive Cancer Center and UCLA School of Nursing, Los Angeles, CA, USA
| | - Donald P Tashkin
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
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Vadhel A, Bashir S, Mir AH, Girdhar M, Kumar D, Kumar A, Mohan A, Malik T, Mohan A. Opium alkaloids, biosynthesis, pharmacology and association with cancer occurrence. Open Biol 2023; 13:220355. [PMID: 37132222 PMCID: PMC10154933 DOI: 10.1098/rsob.220355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/04/2023] [Indexed: 05/04/2023] Open
Abstract
Papaver somniferum L. (Family: Papaveraceae) is a species well known for its diverse alkaloids (100 different benzylisoquinoline alkaloids (BIAs)). L-tyrosine serves as a precursor of several specific metabolites like BIAs. It has been used as an antitussive and potent analgesic to alleviate mild to extreme pain since ancient times. The extraction of pharmaceutically important alkaloids like morphine and codeine from poppy plant reflects the need for the most suitable and standard methods. Several analytical and extraction techniques have been reported in open literature for morphine, codeine and other important alkaloids which play a vital function in drug development and drug discovery. Many studies suggest that opioids are also responsible for adverse effects or secondary complications like dependence and withdrawal. In recent years, opium consumption and addiction are the most important risk factors. Many evidence-based reviews suggest that opium consumption is directly linked or acts as a risk factor for different cancers. In this review, we highlight significant efforts related to research which have been done over the past 5 decades and the complete information on Papaver somniferum including its phytochemistry, pharmacological actions, biosynthetic pathways and analytical techniques of opium alkaloid extraction and the link between opium consumption and cancer-related updates.
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Affiliation(s)
- Agrataben Vadhel
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara 144411, India
| | - Sabreen Bashir
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara 144411, India
| | - Ashiq Hussain Mir
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara 144411, India
| | - Madhuri Girdhar
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara 144411, India
| | - Deepak Kumar
- School of chemical engineering and Physical sciences, Lovely Professional University, Phagwara 144411, India
| | - Anil Kumar
- Gene Regulation Laboratory, National Institute of Immunology, New Delhi 110067, India
| | - Aradhana Mohan
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Tabarak Malik
- Department of Biomedical Sciences, Institute of Health, Jimma University 00000, Ethiopia
| | - Anand Mohan
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara 144411, India
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Khanmohammadi S, Saeedi Moghaddam S, Azadnajafabad S, Rezaei N, Esfahani Z, Rezaei N, Naghavi M, Larijani B, Farzadfar F. Burden of tracheal, bronchus, and lung cancer in North Africa and Middle East countries, 1990 to 2019: Results from the GBD study 2019. Front Oncol 2023; 12:1098218. [PMID: 36844919 PMCID: PMC9951096 DOI: 10.3389/fonc.2022.1098218] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/22/2022] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVE To provide estimates on the regional and national burden of tracheal, bronchus, and lung (TBL) cancer and its attributable risk factors from 1990 to 2019 in the North Africa and Middle East (NAME) region. METHODS AND MATERIALS The Global Burden of Disease (GBD) 2019 data were used. Disability-adjusted life years (DALYs), death, incidence, and prevalence rates were categorized by sex and age groups in the NAME region, in 21 countries, from 1990 to 2019. Decomposition analysis was performed to calculate the proportion of responsible factors in the emergence of new cases. Data are presented as point estimates with their 95% uncertainty intervals (UIs). RESULTS In the NAME region, TBL cancer caused 15,396 and 57,114 deaths in women and men, respectively, in 2019. The age-standardized incidence rate (ASIR) increased by 0.7% (95% UI -20.6 to 24.1) and reached 16.8 per 100,000 (14.9 to 19.0) in 2019. All the age-standardized indices had a decreasing trend in men and an increasing trend in women from 1990 to 2019. Turkey (34.9 per 100,000 [27.6 to 43.5]) and Sudan (8.0 per 100,000 [5.2 to 12.5]) had the highest and lowest age-standardized prevalence rates (ASPRs) in 2019, respectively. The highest and lowest absolute slopes of change in ASPR, from 1990 to 2019, were seen in Bahrain (-50.0% (-63.6 to -31.7)) and the United Arab Emirates (-1.2% (-34.1 to 53.8)), respectively. The number of deaths attributable to risk factors was 58,816 (51,709 to 67,323) in 2019 and increased by 136.5%. Decomposition analysis showed that population growth and age structure change positively contributed to new incident cases. More than 80% of DALYs could be decreased by controlling risk factors, particularly tobacco use. CONCLUSION The incidence, prevalence, and DALY rates of TBL cancer increased, and the death rate remained unchanged from 1990 to 2019. All the indices and contribution of risk factors decreased in men but increased in women. Tobacco is still the leading risk factor. Early diagnosis and tobacco cessation policies should be improved.
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Affiliation(s)
- Shaghayegh Khanmohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Kiel Institute for the World Economy, Kiel, Germany
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Esfahani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Rashidian H, Hadji M, Gholipour M, Naghibzadeh-Tahami A, Marzban M, Mohebbi E, Safari-Faramani R, Bakhshi M, Sadat Seyyedsalehi M, Hosseini B, Alizadeh-Navaei R, Emami H, Haghdoost AA, Rezaianzadeh A, Moradi A, Ansari-Moghaddam A, Nejatizadeh A, ShahidSales S, Rezvani A, Larizadeh MH, Najafi F, Poustchi H, Mohagheghi MA, Brennan P, Weiderpass E, Schüz J, Pukkala E, Freedman ND, Boffetta P, Malekzadeh R, Etemadi A, Rahimi-Movaghar A, Kamangar F, Zendehdel K. Opium use and risk of lung cancer: A multicenter case-control study in Iran. Int J Cancer 2023; 152:203-213. [PMID: 36043555 DOI: 10.1002/ijc.34244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/11/2022]
Abstract
Opium use was recently classified as a human carcinogen for lung cancer by the International Agency for Research on Cancer. We conducted a large, multicenter case-control study evaluating the association between opium use and the risk of lung cancer. We recruited 627 cases and 3477 controls from May 2017 to July 2020. We used unconditional logistic regression analyses to estimate the odds ratios (OR) and 95% confidence intervals (CI) and measured the association between opium use and the risk of lung cancer. The ORs were adjusted for the residential place, age, gender, socioeconomic status, cigarettes, and water pipe smoking. We found a 3.6-fold risk of lung cancer for regular opium users compared to never users (95% CI: 2.9, 4.6). There was a strong dose-response association between a cumulative count of opium use and lung cancer risk. The OR for regular opium use was higher for small cell carcinoma than in other histology (8.3, 95% CI: 4.8, 14.4). The OR of developing lung cancer among opium users was higher in females (7.4, 95% CI: 3.8, 14.5) than in males (3.3, 95% CI: 2.6, 4.2). The OR for users of both opium and tobacco was 13.4 (95% CI: 10.2, 17.7) compared to nonusers of anything. The risk of developing lung cancer is higher in regular opium users, and these results strengthen the conclusions on the carcinogenicity of opium. The association is stronger for small cell carcinoma cases than in other histology.
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Affiliation(s)
- Hamideh Rashidian
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Hadji
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Mahin Gholipour
- Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ahmad Naghibzadeh-Tahami
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Marzban
- Clinical Research Development Center, The Persian Gulf Martyrs, Bushehr University of Medical Science, Bushehr, Iran
- Department of Public Health, School of Public Health, Bushehr University of Medical Science, Bushehr, Iran
| | - Elham Mohebbi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Roya Safari-Faramani
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahdieh Bakhshi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Monireh Sadat Seyyedsalehi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Bayan Hosseini
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- International Agency for Research on Cancer, Lyon, France
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Habib Emami
- National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Akbar Haghdoost
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman, Iran
- Regional Knowledge HUB for HIV/AIDS Surveillance, Research Centre for Modelling in Health, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolvahab Moradi
- Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Azim Nejatizadeh
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | - Alireza Rezvani
- Hematology Research Center, Shiraz University of Medical Science, Fars, Iran
| | - Mohammad Hasan Larizadeh
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Farid Najafi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mohagheghi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | | | - Joachim Schüz
- International Agency for Research on Cancer, Lyon, France
| | - Eero Pukkala
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Finnish Cancer Registry-Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Neal D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
| | - Reza Malekzadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland, USA
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Biology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
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9
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Ilic I, Ilic M. Opium consumption and pancreatic cancer: A meta-analysis. Cancer Epidemiol 2022; 81:102287. [PMID: 36347214 DOI: 10.1016/j.canep.2022.102287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/03/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022]
Abstract
Pancreatic cancer represents a serious public health problem worldwide. Due to its high mortality, efforts on identifying risk factors are very important since only a few risk-related factors have been well established. The present study aimed to address this knowledge gap by estimating the risk of pancreatic cancer associated with opium use. We performed a thorough literature search of PubMed, Web of Science and Scopus, which yielded 3 case-control and 1 cohort study which were included in the analysis. A meta-analysis was conducted using the DerSimonian and Laird inverse-variance approach as the random effects method. The pooled risk ratio for pancreatic cancer in opium users was significantly increased (RR=1.98, 95 % CI 1.33-2.96, p = 0.0008) compared to never users. Subgroup analyses identified a significantly increased risk for pancreatic cancer in men (RR=1.74, 95 % CI 1.22-2.47, p = 0.002), in persons who consumed both raw teriak and refined shireh opium (RR=4.21, 95 % 1.27-13.93, p = 0.02) and in persons who smoked opium (RR=4.21, 95 % 1.27-13.93, p = 0.02). The findings of this study will help in efforts aimed at prevention of pancreatic cancer. Still, further epidemiological research is necessary.
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Affiliation(s)
- Irena Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Milena Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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10
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Farnia V, Nakhaee S, Azadi N, Khanegi M, Ahmadi-Jouybari T, Mansouri B. Comparison of urine trace element levels in tramadol addiction alone and its co-abuse with cigarette and opium in Western Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:77375-77385. [PMID: 35675014 DOI: 10.1007/s11356-022-21271-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Tramadol is an opioid pain medication used to treat moderate to severe pain. Tramadol consumers tend to co-abuse some other substances such as opium, cigarettes, alcohol, and cannabis and each of these substances may impair trace elements homeostasis in the body. Therefore, this case-control study aimed to compare the urinary concentration of some essential and toxic elements in tramadol addiction alone and its co-abuse with cigarette and opium in Western Iran. For this purpose, urine samples were collected in two groups of tramadol (n = 72) and control subjects (n = 62) from March to November 2020. The case group was divided into three groups: tramadol alone, tramadol + opium, and tramadol + cigarettes. Moreover, ICP-MS (Agilent 7900) was used to measure trace element concentrations in the urine samples. Based on our results, Fe was the only element markedly higher among controls as compared to tramadol users (p < 0.001). Moreover, the concentration levels of As appeared to be the same among both groups, but the levels of other elements including Ca, Cd, Cr, Mn, Cu, Zn, Co, Ni, Se, and Pb were all significantly higher among tramadol users as compared to control group. The rank-based regression analysis illustrated that no contribution of sex and age effect was found by the regression model on the levels of all 12 studied elements. While, smoking was found to affect the levels of Fe (β = 0.163, P = 0.025) and Co (β = 0.411, p < 0.001) so that smoking reduced Fe levels but elevated Co concentration levels. Abuse of tramadol along with cigarettes and opium increased the concentration of some heavy metals in urine samples compared to the control group. However, these results showed no significant effect of age, sex, smoking habit, and amount of tramadol usage on the levels of trace elements.
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Affiliation(s)
- Vahid Farnia
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Samaneh Nakhaee
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Nammamali Azadi
- Biostatistics Department, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Khanegi
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Toraj Ahmadi-Jouybari
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Borhan Mansouri
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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11
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Moradi R, Khalili NP, Septiani NLW, Liu CH, Doustkhah E, Yamauchi Y, Rotkin SV. Nanoarchitectonics for Abused-Drug Biosensors. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2022; 18:e2104847. [PMID: 34882957 DOI: 10.1002/smll.202104847] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/14/2021] [Indexed: 06/13/2023]
Abstract
Rapid, accessible, and highly accurate biosensors for the detection of addictive and abused drugs are needed to reduce the adverse personal and societal impacts of addiction. Modern sensors that utilize next-generation technologies, e.g., nanobiotechnology and nanoarchitectonics, have triggered revolutionary progress in the field as they allow accurate detection and tracking of trace levels of major classes of drugs. This paper reviews advances in the field of biosensors for the detection of commonly abused drugs, both prescribed such as codeine and morphine, and illegal narcotics like cocaine.
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Affiliation(s)
- Rasoul Moradi
- Nanotechnology Laboratory, School of Engineering and Applied Science, Khazar University, Baku, Az1096, Azerbaijan
- Department of Chemical Engineering, School of Engineering and Applied Science, Khazar University, Baku, Az1096, Azerbaijan
| | - Nazila Pour Khalili
- Nanotechnology Laboratory, School of Engineering and Applied Science, Khazar University, Baku, Az1096, Azerbaijan
- Center for Cell Pathology Research, Department of Biological Science, Khazar University, Baku, Az1096, Azerbaijan
| | - Ni Luh Wulan Septiani
- Advanced Functional Materials Research Group, Institut Teknologi Bandung, Bandung, 40132, Indonesia
| | - Chia-Hung Liu
- Department of Urology, School of Medicine, College of Medicine, and TMU Research Center of Urology and Kidney, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei, 110, Taiwan
- Department of Urology, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan
| | - Esmail Doustkhah
- International Center for Materials Nanoarchitechtonics (WPI-MANA), National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki, 305-0044, Japan
- JST-ERATO Yamauchi Materials Space-Tectonics Project and International Center for Materials Nanoarchitectonics (WPI-MANA), National Institute for Materials Science (NIMS), 1-1 Namiki, Tsukuba, Ibaraki, 305-0044, Japan
| | - Yusuke Yamauchi
- JST-ERATO Yamauchi Materials Space-Tectonics Project and International Center for Materials Nanoarchitectonics (WPI-MANA), National Institute for Materials Science (NIMS), 1-1 Namiki, Tsukuba, Ibaraki, 305-0044, Japan
- School of Chemical Engineering and Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Slava V Rotkin
- Department of Engineering Science and Mechanics, Materials Research Institute, The Pennsylvania State University, Millennium Science Complex, University Park, PA, 16802, USA
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12
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Azadi N, Nakhaee S, Farnia V, Pirsaheb M, Mansouri B, Ahmadi-Jouybari T, Khanegi M. Multivariate statistical evaluation of heavy metals in the urine of opium individuals in comparison with healthy people in Western Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:8232-8241. [PMID: 34482458 DOI: 10.1007/s11356-021-16271-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
The current study aimed to evaluate the levels of some toxic and essential elements (Pb, Cd, Cu, Ti, Ni, Cr, Co, Fe, Ca, Hg, Mn, Se, and Zn) in the urine of opium-addicted compared to non-addicted cases. In this study, 126 participants were recruited and their fasting urine samples were collected (63 opium-addicted and 63 non-addicted subjects served as the reference group). ICP-MS was utilized to detect the concentration of trace elements. Results exhibited that the concentration of all elements than Ni, Cu, and Zn was markedly different between the addicted and non-addicted groups. Compared to controls, the Cd, Cr, Co, Hg, Mn, Pb, Se, and Ti levels were higher among opium-addicted cases (p < 0.05) whereas the Fe and Ca concentrations were higher among controls (p < 0.05). Robust regression analysis showed no statistically significant effect of gender on element levels. It revealed that age was associated with the levels of Ni and Cu only and also the route of administration was related to the urinary levels of Co, Cr, Hg, and Mn. In conclusion, results confirmed that it is opium consumption that affects the concentration levels of most elements.
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Affiliation(s)
- Nammamali Azadi
- Biostatistics Department, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Samaneh Nakhaee
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Vahid Farnia
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Meghdad Pirsaheb
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Borhan Mansouri
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Toraj Ahmadi-Jouybari
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Khanegi
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Mansouri M, Naghshi S, Parsaeian M, G Sepanlou S, Poustchi H, Momayez Sanat Z, Sadeghi O, Pourshams A. Opium Use and Cancer Risk: A Comprehensive Systematic Review and Meta-Analysis of Observational Studies. Int J Clin Pract 2022; 2022:5397449. [PMID: 35685572 PMCID: PMC9159125 DOI: 10.1155/2022/5397449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/15/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Epidemiological studies have reported inconsistent associations between opium use and cancer risk. We therefore conducted a systematic review and meta-analysis to investigate the relationship between opium use and cancer risk. METHODS We searched PubMed, Scopus, ISI Web of Knowledge, and Google Scholar until February 2021 and references of retrieved relevant articles for observational studies that reported the risk of cancer in relation to opium use. Random-effects models were used to calculate pooled effect sizes (ESs) as well as 95% confidence intervals (CIs) for the association between opium use and cancer risk by considering opium doses and types, duration of consumption, and routes of opium use. RESULTS In total, 21 observational articles, with a total sample size of 64,412 individuals and 6,658 cases of cancer, were included in this systematic review and meta-analysis. Ever opium users, compared with never opium users, had 3.53 times greater risk of overall cancer (pooled ES: 3.53, 95% CI: 2.60-4.79, P ≤ 0.01). This positive association was also seen for some individual types of cancers except for esophageal and colon cancers. Also, we found that higher opium doses and higher duration of consumption were associated with an increased risk of overall and individual types of cancer. However, the associations between opium doses and the risk of head and neck and larynx cancers were not significant. In terms of the routes of opium use, both opium ingestion and smoking were positively associated with the risk of cancer. Regarding opium types, we found that using teriak, but not shireh, could increase the risk of cancer. CONCLUSIONS Our findings showed that opium use, particularly in the form of teriak, is a risk factor for cancer.
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Affiliation(s)
- Masoume Mansouri
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Sina Naghshi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahbobeh Parsaeian
- Department of Biostatistics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sadaf G Sepanlou
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Hossein Poustchi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Zahra Momayez Sanat
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Omid Sadeghi
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akram Pourshams
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
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Veerappa A, Pendyala G, Guda C. A systems omics-based approach to decode substance use disorders and neuroadaptations. Neurosci Biobehav Rev 2021; 130:61-80. [PMID: 34411560 PMCID: PMC8511293 DOI: 10.1016/j.neubiorev.2021.08.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/23/2021] [Accepted: 08/14/2021] [Indexed: 11/15/2022]
Abstract
Substance use disorders (SUDs) are a group of neuropsychiatric conditions manifesting due to excessive dependence on potential drugs of abuse such as psychostimulants, opioids including prescription opioids, alcohol, inhalants, etc. Experimental studies have generated enormous data in the area of SUDs, but outcomes from such data have remained largely fragmented. In this review, we attempt to coalesce these data points providing an important first step towards our understanding of the etiology of SUDs. We propose and describe a 'core addictome' pathway that behaves central to all SUDs. Besides, we also have made some notable observations paving way for several hypotheses; MECP2 behaves as a master switch during substance use; five distinct gene clusters were identified based on respective substance addiction; a central cluster of genes serves as a hub of the addiction pathway connecting all other substance addiction clusters. In addition to describing these findings, we have emphasized the importance of some candidate genes that are of substantial interest for further investigation and serve as high-value targets for translational efforts.
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Affiliation(s)
- Avinash Veerappa
- Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Gurudutt Pendyala
- Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE, 68198, USA; Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE, 68198, USA; Child Health Research Institute, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Chittibabu Guda
- Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE, 68198, USA; Center for Biomedical Informatics Research and Innovation, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
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15
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Naghibzadeh-Tahami A, Marzban M, Yazdi-Feyzabadi V, Khazaei Z, Zahedi MJ, Moazed V, Haghdoost AA. Opium use as an independent risk factor for pancreatic cancer: A case-control study. Cancer Epidemiol 2021; 75:102017. [PMID: 34626910 DOI: 10.1016/j.canep.2021.102017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Pancreatic cancer (PC) is ranked as the seventh leading cause of cancer deaths worldwide. The current study was conducted to explore the correlation between the use of opium and its derivatives (opium) and PC in Iran. METHODS In this case-control study which was conducted in Kerman province, south east part of Iran; 176 patients with PC, and 352 healthy individuals as the control group were matched in terms of age, sex, and place of residence. A structured questionnaire including questions of opium usage, alcohol usage, cigarette smoking, and diet was used to collect the data. The relation between the use of opium and PC was adjusted for tobacco smoking, education, daily intake of fruit, vegetables, red meat, and hydrogenated fats and analyzed using the conditional logistic regression. RESULTS There was a positive relationship between the opium use and the increased risk of PC (Adjusted Odds Ratio (AOR) = 4.33, 95 % CI: 2.09-8.95), which was even stronger than its association with cigarette smoking (AOR = 1.67, 95 % CI: 0.86-3.24), although their difference was not statistically significant. A significant dose-response relation was detected between the use of opium; as the relation was stronger in heavy users (AOR low users = 4.93, 95 % CI: 1.79-13.54 and AOR heavy users = 5.10, 95 % CI: 2.10-12.35). Moreover, PC was higher among participants starting the use of opium at a younger age than those who started opium at an older age (AOR = 8.03, 95 % CI: 3.19-20.23). CONCLUSION This study demonstrated that opium use is associated with a high and strong risk of PC as an independent risk factor. Further studies should be done to reduce the use of opium in Iran and other world countries.
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Affiliation(s)
- Ahmad Naghibzadeh-Tahami
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Marzban
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Zaher Khazaei
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohammad Javad Zahedi
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Moazed
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences Kerman, Iran
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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16
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Hedayati-Moghadam M, Moezi SA, Kazemi T, Sami A, Akram M, Zainab R, Khazdair MR. The effects of Papaver somniferum (Opium poppy) on health, its controversies and consensus evidence. TOXIN REV 2021. [DOI: 10.1080/15569543.2021.1958232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | - Seyyed Ali Moezi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Toba Kazemi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Abdul Sami
- University College of Conventional Medicine, Faculty of Medicine and Allied Health Sciences, The Islamia University of Bahawalpur, Pakistan
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Pakistan
| | - Rida Zainab
- Department of Eastern Medicine, Government College University Faisalabad, Pakistan
| | - Mohammad Reza Khazdair
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
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Singh G, Jaiswal A, Goel AD, Raghav P. Opium Usage and Risk of Head and Neck Cancer: A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev 2021; 22:661-670. [PMID: 33773527 PMCID: PMC8286690 DOI: 10.31557/apjcp.2021.22.3.661] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 03/09/2021] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Opium is among the most used substance of abuse worldwide. More than 50 million opium users are there worldwide, majority of whom are in Asia. Opium usage have been reported to be associated with cancer. This study aimed to find the association between opium use or abuse and head and neck cancer. METHODS A systematic search was conducted in Medline, Scopus, Cochrane, and Google Scholar database for studies published from inception till 1st November 2019. Two authors independently reviewed the studies, did quality assessment, and extracted data in standardized data extraction form. Pooled estimate of OR for risk of head and neck cancer was calculated using random effects model using the method of DerSimonian and Laird, with the estimate of heterogeneity being taken from the inverse-variance model. Subgroup and sensitivity analysis were performed. The protocol was registered in PROSPERO (CRD42020156049). RESULTS Fourteen studies were included in data synthesis (11 case control studies and 3 cohort studies). Eleven case control studies were included in synthesizing the results for meta-analysis. Pooled odds ratio for risk of cancer among opium users for the 11-case control study was 3.85 (2.18-6.79). Heterogeneity was high (I-squared=92.0%, Tau-squared=0.88). There was no publication bias in the study. Subgroup analysis showed highest OR for pooled estimate for risk of laryngeal cancer (19.98 (11.04-36.15)). CONCLUSION There was almost four-fold rise in risk of head and neck cancer among opium users compared to non-users.
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Affiliation(s)
- Garima Singh
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Abhishek Jaiswal
- All India Institute of Medical Sciences, New Delhi, Delhi, India.
| | - Akhil D Goel
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Pankaja Raghav
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
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18
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Bidary MZ, Sahranavard M, Rezayat AA, Omranzadeh A, Hoseiny SH, Kabirian A, Sahebkar A. Opium as a carcinogen: A systematic review and meta-analysis. EClinicalMedicine 2021; 33:100768. [PMID: 33718852 PMCID: PMC7921501 DOI: 10.1016/j.eclinm.2021.100768] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Opium and its pyrolysates have been investigated as potential carcinogenic material through several studies in different body systems; however, the results were controversial and no consensus was achieved with this regard. Thus, we aimed to systematically review and meta-analyze all existed evidence regarding association between opium consumption and cancer. METHODS Four major electronic databases including ISI Web of Science, PubMed, Scopus, and Embase along with Magiran and SID were searched thoroughly for all published articles from inception up to September 25, 2020. All studies were appraised critically by Newcastle Ottawa Scale (NOS) checklist. Relevant demographic data and the intended results of the selected studies were extracted and their Odds ratios (OR) were pooled using Comprehensive Meta-analysis (CMA). The cumulative risk of opium for developing different cancers was calculated. FINDINGS 34 studies comprised of 18,230 individuals were entered in our systematic review and finally 32 publications were enrolled in meta-analysis. Overall, using the random effects model, opium consumption was associated with increased rate of malignancies in both minimally[OR = 4.14 95%CI = (3.32-5.15)] and fully adjusted [OR = 4.35 95%CI = (3.36-5.62)] analyses. Moreover, using random effects fully adjusted model, the subgroup analysis revealed increased risk for larynx [OR = 9.58 95%CI = (6.31-14.53)], respiratory [OR = 9.02 95%CI = (6.27-12.96)], head and neck [OR = 8•03 95%CI = (4.03-16.00)], and colon [OR=5.58 95%CI = (3.14-9.92)] cancers for opium consumers compared to non-consumers. INTERPRETATION Opium consumption is highly associated with all reported types of cancers, especially in fully adjusted model; however, basic pathophysiology should be further investigated. FUNDING None.
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Affiliation(s)
- Mohammad Zamiri Bidary
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mehrdad Sahranavard
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arash Akhavan Rezayat
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Omranzadeh
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyyed Hasan Hoseiny
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Kabirian
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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19
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Mohebbi E, Hadji M, Rashidian H, Rezaianzadeh A, Marzban M, Haghdoost AA, Naghibzadeh Tahami A, Moradi A, Gholipour M, Najafi F, Safari-Faramani R, Alizadeh-Navaei R, Ansari-Moghaddam A, Bakhshi M, Nejatizadeh A, Mahmoudi M, Shahidsales S, Ahmadi-Simab S, Arabi Mianroodi AA, Seyyedsalehi MS, Hosseini B, Peyghambari V, Shirkhoda M, Shirkoohi R, Ebrahimi E, Manifar S, Mohagheghi MA, Rozek L, Brennan P, Poustchi H, Etemadi A, Pukkala E, Schüz J, Malekzadeh R, Weiderpass E, Rahimi-Movaghar A, Boffetta P, Kamanagar F, Zendehdel K. Opium use and the risk of head and neck squamous cell carcinoma. Int J Cancer 2021; 148:1066-1076. [PMID: 32895947 DOI: 10.1002/ijc.33289] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/13/2020] [Accepted: 07/24/2020] [Indexed: 02/05/2023]
Abstract
Scant evidence exists to support the association of opium use with head and neck cancer, limited to the larynx and oral cavity. In a multicenter case-control study-Iran Opium and Cancer study, we recruited 633 cases of head and neck squamous cell carcinoma (HNSCC) (254 lip and oral cavity, 54 pharynx, 327 larynx and 28 other subsites within the head and neck) and 3065 frequency-matched controls from April 2016 to April 2019. Odds ratios (ORs) for opium use and 95% confidence intervals (95% CIs) were obtained using mixed-effects logistic regression because of heterogeneity among centers. The adjusted OR (95% CI) for regular opium use was 3.76 (2.96-4.79) for all HNSCC combined. Strong dose-response effects were observed by frequency or amount of use, and duration of use. Regular opium uses significantly increased the risk of HNSCC of the pharynx, larynx and other subsites within the head and neck with OR (95% CI) of 2.90 (1.40-6.02), 6.55 (4.69-9.13) and 5.95 (2.41-14.71), respectively. The observed associations were significant even among never tobacco smokers (including cigarette and water-pipe smoking). Moreover, by the multiplicative interaction scale, the effect of opium use could be varied by cigarette smoking on HNSCC, 8.16 (6.20-10.74). For the first time, the current study showed opium users have an increased risk of several anatomic subsites of HNSCC.
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Affiliation(s)
- Elham Mohebbi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
- Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Hadji
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
- Health Science Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Hamideh Rashidian
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Abass Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Marzban
- School of Public Health, Department of Epidemiology and Biostatistics, Bushehr University of Medical Sciences, Bushehr, Iran
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, The Persian Gulf Department of Aging Health Research, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Ali Akbar Haghdoost
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmad Naghibzadeh Tahami
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abdolvahab Moradi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahin Gholipour
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, Institute of Health, Kermanshah Medical Sciences University, Kermanshah, Iran
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roya Safari-Faramani
- Research Center for Environmental Determinants of Health, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-communicable diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Mahdieh Bakhshi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Azim Nejatizadeh
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | | | | | - Ali Asghar Arabi Mianroodi
- Department of Otorhinolaryngology Head and Neck Surgery, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Bayan Hosseini
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Vahideh Peyghambari
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shirkhoda
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shirkoohi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Elmira Ebrahimi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Manifar
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mohagheghi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Laura Rozek
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Paul Brennan
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Eero Pukkala
- Health Science Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Finnish Cancer Registry, Helsinki, Finland
| | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Farin Kamanagar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland, USA
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
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20
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Ramirez MF, Gorur A, Cata JP. Opioids and cancer prognosis: A summary of the clinical evidence. Neurosci Lett 2021; 746:135661. [PMID: 33482308 DOI: 10.1016/j.neulet.2021.135661] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/05/2021] [Accepted: 01/11/2021] [Indexed: 12/20/2022]
Abstract
Pain is a common and devastating symptom among cancer patients. It can be caused by the cancer itself or by certain therapies like surgery, radiation or chemotherapy. Opioids are the first line of treatment for moderate to severe cancer-related pain. Opioids alone or in combination with non-opioid analgesics and adjuvant medications are important components for pain management during the perioperative period for cancer patients. Opioids act on the μ-opioid receptor (MOR), which is expressed in cancer cells and non-malignant cells of the tumor microenvironment. Retrospective studies suggest an association between the expression of MOR in cancers and shorter survival. In addition, recent evidence suggests that opium use and prescription opioids can influence clinical oncological outcomes. In this review, we will summarize the clinical evidence regarding the effect of opioid administration and survival in patients with cancer as well as the current evidence involving MOR expression and cancer progression.
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Affiliation(s)
- Maria F Ramirez
- Department of Anesthesiology and Perioperative Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA; Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA
| | - A Gorur
- Department of Anesthesiology and Perioperative Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA; Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA
| | - Juan P Cata
- Department of Anesthesiology and Perioperative Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA; Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA.
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21
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Ebrahimi E, Akhavan MH, Akrami R, Mahmoodi M, Hesami S, Hashemi M, Razavi SM, Hadji M, Zendehdel K. Association between mitochondrial DNA content and opium exposure. J Biochem Mol Toxicol 2020; 34:e22559. [PMID: 33034947 DOI: 10.1002/jbt.22559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/10/2020] [Accepted: 05/29/2020] [Indexed: 01/09/2023]
Abstract
To date, not much study has been done to investigate the mitochondrial DNA (mtDNA) copy number as the potential biomarker for opium exposure. Here, we conducted a cross-sectional study to determine the relative mtDNA content as the potential biomarker for opium exposure. Quantitative real-time PCR was performed to investigate the mtDNA copy number variation across 205 individuals, including blood samples of 45 opium users, 41 cigarette users, 47 dual users, and 72 never users of any product. We found a significantly higher mtDNA content among the opium-only users (adjusted OR: 3.21; 95% CI: [1.34, 7.66]; P = .009) and dual users (adjusted OR: 2.64; 95% CI: [1.15, 6.1]; P = .02) compared to that in never users even after adjustment for confounding factors, age, and sex. Discordantly, analysis of mitochondrial DNA in cigarette smokers revealed an indirect association between cigarette smoking and mtDNA content although it was not statistically significant. The reason behind the increased mitochondrial DNA is unclear. The possible hypothesis is that there might be a way to compensate for the oxidative damage induced by opium consumption. Taken together, our findings indicated that the mtDNA copy number may alter during opium exposure. Since changes in the mitochondrial DNA copy number was associated with the etiology of many diseases including cancer, further investigations on the mtDNA copy number may shed light on the carcinogenicity of opium consumption and means for early detection among the populations who have been exposed to opium and its products.
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Affiliation(s)
- Elmira Ebrahimi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.,Cancer Biology Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran, Iran
| | - Mohammad H Akhavan
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.,Department of Genetics, Faculty of Advanced Sciences and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Rahim Akrami
- Department of Epidemiology & Biostatistics, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.,Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Mahmoodi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Hesami
- Medical Genetics Department, Cancer Institute, Imam Khomeini Hospital, Tehran, Iran
| | - Mehrdad Hashemi
- Department of Genetics, Faculty of Advanced Sciences and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Seyed M Razavi
- Department of Occupational Health Engineering, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Maryam Hadji
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.,Health Science Unit, Faculty of Social Science, Tampere University, Tampere, Finland
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.,Cancer Biology Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran, Iran
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22
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23
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Naghibzadeh-Tahami A, Marzban M, Yazdi-Feyzabadi V, Dabiri S, Mohseni S, Abbasi Rayeni R, Samareh Fekri M, Larizadeh MH, Karimpour B, Khanjani N. Is opium use associated with an increased risk of lung cancer? A case-control study. BMC Cancer 2020; 20:807. [PMID: 32842991 PMCID: PMC7448970 DOI: 10.1186/s12885-020-07296-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 08/12/2020] [Indexed: 12/29/2022] Open
Abstract
Background In recent years, lung cancer (LC) incidence has increased in Iran. The use of opium and its derivatives (O&D) has increased as well. This study aimed to investigate the association between the use of O&D and LC incidence. Methods In this case-control study conducted in Kerman, Iran; 140 patients with lung cancer and 280 healthy controls matched by age, sex, and place of residence were included. Data, including O&D use, cigarette smoking, alcohol use, and diet, were collected using a structured questionnaire. The relation between the use of O&D and LC was evaluated using conditional logistic regression adjusted for tobacco smoking, education, daily intake of fruit, vegetables, red meat, and hydrogenated fats. Results Opium ever-use was associated with an increased risk of LC (Adjusted Odds Ratio (AOR) =5.95, 95% CI: 1.87–18.92). Participants were divided into low and high use groups based on the median of opium use in the control group. A significant dose-response relation was observed between the amount of daily O&D use and LC; and the relation was stronger in high users (AOR low users = 3.81% CI: 1.13–12.77 and OR high users = 9.36, 95% CI: 2.05–42.72). Also, LC was higher among participants starting the use of O&D at younger ages (≤ 41 years old vs never users AOR = 8.64, 95% CI: 1.90–39.18) compared to those who started at an older age (> 41 years old vs never users, AOR = 4.71, 95% CI: 1.38–16.08). The association between opium, and lung cancer among non-smokers was OR: 6.50 (95% CI: 2.89 to 14.64). Conclusion The results of this study show that opium use is probably a dose related risk factor for lung cancer.
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Affiliation(s)
| | - Maryam Marzban
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Vahid Yazdi-Feyzabadi
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahryar Dabiri
- Pathology and Stem Cell Research Center, Department of Pathology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Reza Abbasi Rayeni
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mitra Samareh Fekri
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Hasan Larizadeh
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Behnaz Karimpour
- Social Determinants of Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran. .,Monash Centre for Occupational & Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. .,Department of Epidemiology and Biostatistics, Faculty of Public Health, Kerman Medical University (KMU), Haft Bagh Alavi Highway, Kerman, 76169-11317, Iran.
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24
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Vazirinejad R, Najafipour R, Rezaeian M, Ghazizadeh A, Doost Mohammadi F. Opium and risk of gastrointestinal cancer: a case-control study. Turk J Med Sci 2020; 50:697-705. [PMID: 32041383 PMCID: PMC7379408 DOI: 10.3906/sag-1907-100] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 02/09/2020] [Indexed: 12/12/2022] Open
Abstract
Background/aim Gastrointestinal (GI) cancers are among the most common cancers in the world. Many risk factors may increase the chance of developing GI cancers. In recent years, a number of epidemiological studies have reported evidence of carcinogenic effects of opium in humans. This study aimed to investigate the relationship between opium use and GI cancer. Materials and methods This case-control study was performed on 95 patients with GI cancer and 190 healthy individuals (matched for age, sex, place of residence, and smoking) in Rafsanjan, Iran, in 2018. Diet information, as well as history of smoking, the use of hookah, opium, and its derivatives was collected using a checklist in interview sessions. Conditional logistic regression was performed to investigate the proposed relationship and to estimate odds ratios (OR). Results After adjusting the confounding variables, the use of opium was significantly associated with an increased risk of GI cancer development (OR = 5.95, 95% CI: 2.4–14.9). Also, a dose-response association was found between the cumulative use of opium and the risk of GI cancers. Consumption of fruit and vegetables reduced the risk of developing GI cancers in opium users (OR = 4.9 and 4.7, respectively). Conclusion Opium, in the form used among drug users in this area, can lead to an increased risk of GI cancers. Fruit and vegetables have a protective and modifying effect on the risk of GI cancer development caused by opium consumption.
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Affiliation(s)
- Reza Vazirinejad
- Department of Epidemiology and Biostatics, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Roya Najafipour
- Department of Public Health, School of Health, Bam University of Medical Sciences, Bam, Iran
| | - Mohsen Rezaeian
- Department of Epidemiology and Biostatics, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Alireza Ghazizadeh
- Department of Internal Medicine, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Fateme Doost Mohammadi
- Department of Epidemiology and Biostatics, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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25
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Firouzabadi N, Haghnegahdar M, Khalvati B, Dehshahri A, Bahramali E. Overexpression of Adiponectin Receptors in Opium Users with and without Cancer. Clin Pharmacol 2020; 12:59-65. [PMID: 32607004 PMCID: PMC7304683 DOI: 10.2147/cpaa.s256289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/05/2020] [Indexed: 11/23/2022] Open
Abstract
Aim Opium addiction is a serious public health concern in the Middle East countries causing various illnesses. Opium use is associated with an increased risk of several cancers; however, the underlying mechanisms are not yet fully elucidated. Altered levels of adiponectin and its related main receptors, Adiponectin receptor 1 and 2 (AdipoR1 and AdipoR2) have been associated with several malignancies. Opium users are at risk of various cancers. All together let us to the hypothesis that probable overexpression of AdipoRs in opium users might be linked to the occurrence of cancer in this population. Methods One hundred opium users along with 100 healthy non-opium users were enrolled in the study. Opium users were followed up for 5 years (2014–2019) to evaluate the occurrence of malignancies. AdipoR1 and AdipoR2 expressions were measured using a flow cytometry method. Results Expression of AdipoR1 and AdipoR2 was significantly higher in opium users compared with the healthy control group (P=0.0001 and 0.0001, respectively). Eight opium users developed cancer during the follow-up period. Subjects abusing opium developed cancer by 8.6 folds comparing to non-opium users (P=0.034; OR=8.6; 95% CI (1.06–70.1)). Expression of these two receptors was significantly higher in opium users developing cancer compared with cancer-free opium (P=0.001). Conclusion Considering the significant overexpression of AdipoR1 and AdipoR2 in opium users and in opium users who developed malignancies and the association between upregulation of these receptors in most cancers affecting opium users and assessment of AdipoRs may serve as an early detection tool of cancer in this population.
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Affiliation(s)
- Negar Firouzabadi
- Department of Pharmacology & Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.,Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Non-Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Maral Haghnegahdar
- Department of Pharmacology & Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahman Khalvati
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Ali Dehshahri
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Bahramali
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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26
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Sheikh M, Shakeri R, Poustchi H, Pourshams A, Etemadi A, Islami F, Khoshnia M, Gharavi A, Roshandel G, Khademi H, Sepanlou SG, Hashemian M, Fazel A, Zahedi M, Abedi-Ardekani B, Boffetta P, Dawsey SM, Pharoah PD, Sotoudeh M, Freedman ND, Abnet CC, Day NE, Brennan P, Kamangar F, Malekzadeh R. Opium use and subsequent incidence of cancer: results from the Golestan Cohort Study. Lancet Glob Health 2020; 8:e649-e660. [PMID: 32353313 PMCID: PMC7196888 DOI: 10.1016/s2214-109x(20)30059-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 12/15/2022]
Abstract
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. METHODS This 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 (ptrend<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 (ptrend<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 (prend<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. FUNDING World Cancer Research Fund International, Cancer Research UK, Tehran University of Medical Sciences, US National Cancer Institute, International Agency for Research on Cancer.
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Affiliation(s)
- Mahdi Sheikh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Section of Genetics, International Agency for Research on Cancer, WHO, Lyon, France
| | - Ramin Shakeri
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Farhad Islami
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - Masoud Khoshnia
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolsamad Gharavi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Gholamreza Roshandel
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hooman Khademi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadaf G Sepanlou
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Hashemian
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Biology, School of Arts and Sciences, Utica College, Utica, NY, USA
| | - Abdolreza Fazel
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahdi Zahedi
- Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Sanford M Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Paul D Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Masoud Sotoudeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Neal D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Christian C Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Nicholas E Day
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Paul Brennan
- Section of Genetics, International Agency for Research on Cancer, WHO, Lyon, France
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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27
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Alizadeh H, Naghibzadeh Tahami A, Khanjani N, Yazdi-Feyzabadi V, Eslami H, Borhaninejad V, Larizadeh MH, Enhesari A, Abbasi-Rayeni R, Moazed V, Arabi Mianroodi A. Opium Use and Head and Neck Cancers: A Matched Case-Control Study in Iran. Asian Pac J Cancer Prev 2020; 21:783-790. [PMID: 32212808 PMCID: PMC7437338 DOI: 10.31557/apjcp.2020.21.3.783] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Indexed: 12/24/2022] Open
Abstract
Background: Head and Neck (H and N) cancers include malignant tumors of the nasal cavity, pharynx, paranasal sinuses, oral cavity, larynx and salivary glands. Opium use might be related to these cancers. The aim of this study was to investigate the relation between Opium and its Derivatives (O and D) use and the incidence of H and N cancers. Methods: In this case-control study conducted in Kerman, 140 patients with H and N cancers and 280 healthy controls (matched for age, gender, and place of residence) were included. Information about their use of O and D, cigarette smoking, alcohol and diet were collected using a structured questionnaire. Conditional logistic regression was used to investigate the relation between variables. Results: The use of opioids was associated with an increased risk of HandN cancers (Adjusted OR: 8.13; CI: 4.08-16.2). A significant dose-response relation between O and D use was observed, with high use Adjusted OR=8.91; 95% CI: 4.03-19.65 and low use Adjusted OR=6.52; 95% CI: 3.18- 13.36. This dose-response association was stronger in patients with laryngeal cancer and opioids use, with high use Adjusted OR = 11.17; 95% CI=4.48-28.09 and low use Adjusted OR = 9.46; 95% CI= 3.97- 22.52. Conclusion: The results show that opium use can be considered as an important risk factor for H and N cancers. Also in Iran, opium seems to play a more important role than cigarette smoking.
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Affiliation(s)
- Hosniyeh Alizadeh
- Neuroscience Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmad Naghibzadeh Tahami
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran.,Adjunct Research Fellow, Monash Centre for Occupational & Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hadi Eslami
- Department of Otorhinolaryngology Head and Neck Surgery, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahidreza Borhaninejad
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Hasan Larizadeh
- Department of Radiation Oncology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmad Enhesari
- Clinical Research Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Abbasi-Rayeni
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Moazed
- Department of Hematology and Oncology, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Aliasghar Arabi Mianroodi
- Department of Otorhinolaryngology Head and Neck Surgery, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
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28
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Ni X, Xu N, Wang Q. Meta-Analysis and Systematic Review in Environmental Tobacco Smoke Risk of Female Lung Cancer by Research Type. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1348. [PMID: 29954105 PMCID: PMC6068922 DOI: 10.3390/ijerph15071348] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/23/2018] [Accepted: 06/25/2018] [Indexed: 12/14/2022]
Abstract
More than 50% of women worldwide are exposed to Environmental Tobacco Smoke (ETS). The impact of ETS on lung cancer remains unclear. Cohort studies since the late 1990s have provided new evidence of female lung cancer risk due to ETS. The objective of this meta-analysis and systematic review was to analyze the association of ETS with female lung cancer risk from 1997 to 2017, organised based on research design. According to our applied inclusion and exclusion criteria, 41 published studies were included. The relative risk (RR) from the cohort studies or odds ratio (OR) from case-control studies were extracted to calculate the pooled risks based on the type of study. The summary risks of ETS were further explored with the modulators of ETS exposure sources and doses. The pooled risks of lung cancer in non-smoking women exposed to ETS were 1.35 (95% CI: 1.17⁻1.56), 1.17 (95% CI: 0.94⁻1.44), and 1.33 (95% CI: 1.17⁻1.51) for case-control studies, cohort studies, and both types of studies, respectively. The summary RR estimate of the cohort studies was not statistically significant, but the RR increased with increasing doses of ETS exposure (p trend < 0.05). Based on the results of this study, ETS might be an important risk factor of female lung cancer in non-smokers.
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Affiliation(s)
- Xue Ni
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing 100050, China.
| | - Ning Xu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing 100050, China.
| | - Qiang Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing 100050, China.
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29
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Moossavi S, Mohamadnejad M, Pourshams A, Poustchi H, Islami F, Sharafkhah M, Mirminachi B, Nasseri-Moghaddam S, Semnani S, Shakeri R, Etemadi A, Merat S, Khoshnia M, Dawsey SM, Pharoah PD, Brennan P, Abnet CC, Boffetta P, Kamangar F, Malekzadeh R. Opium Use and Risk of Pancreatic Cancer: A Prospective Cohort Study. Cancer Epidemiol Biomarkers Prev 2018; 27:268-273. [PMID: 29263189 PMCID: PMC5835180 DOI: 10.1158/1055-9965.epi-17-0592] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/10/2017] [Accepted: 12/14/2017] [Indexed: 12/27/2022] Open
Abstract
Background: We examined the association between opium consumption and pancreatic cancer incidence in a large-scale prospective cohort of the general population in northeastern Iran.Methods: A total of 50,045 adults were systematically followed up (median of 7.4 years), and incident cases of pancreatic cancer were identified. Self-reported data on opium consumption was collected at baseline. Cumulative use (-year) was defined as number of nokhods (a local unit, approximately 0.2 g) of opium consumed per day multiplied by number of years consuming. Adjusted HRs and 95% confidence intervals (CIs) for the association between opium consumption and pancreatic cancer were calculated using Cox proportional hazards regression models.Results: Overall, 54 confirmed cases of pancreatic cancer were identified. Opium use of more than 81 nokhod-years (high cumulative use), compared with never use, was strongly associated with pancreatic cancer even after adjustments for multiple potential confounding factors [HR = 3.01; 95% CI, 1.25-7.26]. High cumulative consumption of opium was significantly associated with risk of pancreatic cancer after adjusting for cumulative dose of cigarette smoking [HR = 3.56; 95% CI, 1.49-8.50]. In a sensitivity analysis, we excluded participants (including 2 pancreatic cancer cases) who were recruited within the first 5 years of starting opium consumption; high cumulative use of opium was still associated with pancreatic cancer risk [HR = 2.75; 95% CI, 1.14-6.64].Conclusions: Our results showed a positive association between opium consumption and pancreatic cancer.Impact: This is the first prospective large-scale study to show the association of opium consumption with pancreatic cancer as a risk factor. Cancer Epidemiol Biomarkers Prev; 27(3); 268-73. ©2017 AACR.
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Affiliation(s)
- Shirin Moossavi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohamadnejad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourshams
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Mirminachi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Siavosh Nasseri-Moghaddam
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahryar Semnani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ramin Shakeri
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Shahin Merat
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Khoshnia
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Sanford M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Paul D Pharoah
- Departments of Oncology and Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Paolo Boffetta
- The Tisch Cancer Institute and Institute for Transitional Epidemiology, Mount Sinai School of Medicine, New York, New York
| | - Farin Kamangar
- School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland
| | - Reza Malekzadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Rahmati A, Shakeri R, Khademi H, Poustchi H, Pourshams A, Etemadi A, Khoshnia M, Sohrabpour AA, Aliasgari A, Jafari E, Islami F, Semnani S, Gharavi S, Abnet CC, Pharoah PDP, Brennan P, Boffetta P, Dawsey SM, Malekzadeh R, Kamangar F. Mortality from respiratory diseases associated with opium use: a population-based cohort study. Thorax 2017; 72:1028-1034. [PMID: 27885167 PMCID: PMC5759041 DOI: 10.1136/thoraxjnl-2015-208251] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 09/11/2016] [Accepted: 10/16/2016] [Indexed: 01/08/2023]
Abstract
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, 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 non-malignant aetiologies). Opium use was associated with an increased risk of death from any respiratory disease (adjusted HR 95% CI 3.13 (2.42 to 4.04)). The association was dose-dependent with a HR of 3.84 (2.61 to 5.67) for the highest quintile of cumulative opium use versus never use (Ptrend<0.001). The HRs (95% CI) for the associations between opium use and malignant and non-malignant causes of respiratory mortality were 1.96 (1.18 to 3.25) and 3.71 (2.76 to 4.96), respectively. CONCLUSIONS Long-term opium use is associated with increased mortality from both malignant and non-malignant respiratory diseases.
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Affiliation(s)
- Atieh Rahmati
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Shakeri
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hooman Khademi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Masoud Khoshnia
- Golestan Research Center of Gastroenterology& Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran
| | - Amir Ali Sohrabpour
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Aliasgari
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Jafari
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Islami
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- American Cancer Society, Atlanta, USA
| | - Shahryar Semnani
- Golestan Research Center of Gastroenterology& Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran
| | - Samad Gharavi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology& Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran
| | - Christian C. Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Paul DP Pharoah
- Departments of Oncology and Public Health and Primary Care University of Cambridge, Cambridge, UK
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Paolo Boffetta
- The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sanford M. Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farin Kamangar
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD
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31
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lankarani KB, Khosravizadegan Z, Naghibzadeh-Tahami A, Akbari M, Khodadost M, Honarvar B, Khodadost B, Goodarzi F, Jokari K, Akbari M, Sekhavati E, Tabrizi R. Opium Use and Risk of Lower Gastrointestinal Cancers: Population-Based Case-Control Study in South of Iran. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2017; 10. [DOI: 10.5812/ijcm.8227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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32
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Shakeri R, Kamangar F, Mohamadnejad M, Tabrizi R, Zamani F, Mohamadkhani A, Nikfam S, Nikmanesh A, Sotoudeh M, Sotoudehmanesh R, Shahbazkhani B, Ostovaneh MR, Islami F, Poustchi H, Boffetta P, Malekzadeh R, Pourshams A. Opium use, cigarette smoking, and alcohol consumption in relation to pancreatic cancer. Medicine (Baltimore) 2016; 95:e3922. [PMID: 27428185 PMCID: PMC4956779 DOI: 10.1097/md.0000000000003922] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND AND AIMS Although several studies have suggested opium as a risk factor for cancers of the esophagus, stomach, larynx, lung, and bladder, no previous study has examined the association of opium with pancreatic cancer. We aimed to study the association between opium use and risk of pancreatic cancer in Iran, using a case-control design. We also studied the association of cigarette smoking and alcohol consumption with pancreatic cancer, for which little information was available from this population. METHODS Cases and controls were selected from patients who were referred to 4 endoscopic ultrasound centers in Tehran, Iran. We recruited 316 histopathologically (all adenocarcinoma) and 41 clinically diagnosed incident cases of pancreatic cancer, as well as 328 controls from those with a normal pancreas in enodosonography from January 2011 to January 2015. We used logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS After adjustment for potential confounders, opium use (OR 1.91; 95% CI 1.06-3.43) and alcohol consumption (OR 4.16; 95% CI 1.86-9.31) were significantly associated with an increased risk of pancreatic cancer. We did not find an association between ever tobacco smoking and pancreatic cancer risk (OR 0.93; 95% CI 0.62-1.39). CONCLUSION In our study, opium use and alcohol consumption were associated with an increased risk of pancreatic cancer, whereas cigarette smoking was not.
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Affiliation(s)
- Ramin Shakeri
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farin Kamangar
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD
- Correspondence: Akram Pourshams, Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (e-mail: ); Farin Kamangar, Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Portage Avenue Campus, Baltimore, MD (e-mail: )
| | - Mehdi Mohamadnejad
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | - Reza Tabrizi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Disease Research Center, Firoozgar Hospital, Iran University of Medical Sciences
| | - Ashraf Mohamadkhani
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD
| | - Sepideh Nikfam
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | - Arash Nikmanesh
- Sasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Clinic, Tehran, Iran
| | - Masoud Sotoudeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasoul Sotoudehmanesh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | - Bijan Shahbazkhani
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | - Mohammad Reza Ostovaneh
- Division of Gastroenterology and Hepatology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins Medical Institutions, Baltimore, MD
| | - Farhad Islami
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- American Cancer Society, Atlanta, GA
| | - Hossein Poustchi
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | - Paolo Boffetta
- Institute for Transitional Epidemiology and the Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourshams
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
- Correspondence: Akram Pourshams, Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (e-mail: ); Farin Kamangar, Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Portage Avenue Campus, Baltimore, MD (e-mail: )
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Alimohammadi H, Fakhri S, Derakhshanfar H, Hosseini-Zijoud SM, Safari S, Hatamabadi HR. The Effects of Air Pollution on Ischemic Stroke Admission Rate. Chonnam Med J 2016; 52:53-8. [PMID: 26866000 PMCID: PMC4742610 DOI: 10.4068/cmj.2016.52.1.53] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 12/21/2015] [Accepted: 12/23/2015] [Indexed: 11/28/2022] Open
Abstract
The present study aimed to determine the relationship between the level of air pollutants and the rate of ischemic stroke (IS) admissions to hospitals. In this retrospective cross-sectional study, stroke admissions (January-March 2012 and 2013) to an emergency department and air pollution and meteorological data were gathered. The relationship between air pollutant levels and hospital admission rates were evaluated using the generalize additive model. In all 379 patients with IS were referred to the hospital (52.5% male; mean age 68.2±13.3 years). Both transient (p<0.001) and long-term (p<0.001) rises in CO level increases the risk of IS. Increased weekly (p<0.001) and monthly (p<0.001) average O3 levels amplifies this risk, while a transient increase in NO2 (p<0.001) and SO2 (p<0.001) levels has the same effect. Long-term changes in PM10 (p<0.001) and PM2.5 (p<0.001) also increase the risk of IS. The findings showed that the level of air pollutants directly correlates with the number of stroke admissions to the emergency department.
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Affiliation(s)
- Hossein Alimohammadi
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Fakhri
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hojjat Derakhshanfar
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Mostafa Hosseini-Zijoud
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeed Safari
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Hatamabadi
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lee PN, Fry JS, Forey BA, Hamling JS, Thornton AJ. Environmental tobacco smoke exposure and lung cancer: A systematic review. World J Meta-Anal 2016; 4:10. [DOI: 10.13105/wjma.v4.i2.10] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/19/2016] [Accepted: 03/14/2016] [Indexed: 02/05/2023] Open
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Hosseini M, Naghan PA, Jafari AM, Yousefifard M, Taslimi S, Khodadad K, Mohammadi F, Sadr M, Rezaei M, Mortaz E, Masjedi MR. Nutrition and lung cancer: a case control study in Iran. BMC Cancer 2014; 14:860. [PMID: 25416035 PMCID: PMC4247167 DOI: 10.1186/1471-2407-14-860] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 11/11/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite many prospective and retrospective studies about the association of dietary habit and lung cancer, the topic still remains controversial. So, this study aims to investigate the association of lung cancer with dietary factors. METHOD In this study 242 lung cancer patients and their 484 matched controls on age, sex, and place of residence were enrolled between October 2002 to 2005. Trained physicians interviewed all participants with standardized questionnaires. The middle and upper third consumer groups were compared to the lower third according to the distribution in controls unless the linear trend was significant across exposure groups. RESULT Conditional logistic regression was used to evaluate the association with lung cancer. In a multivariate analysis fruit (Ptrend < 0.0001), vegetable (P = 0.001) and sunflower oil (P = 0.006) remained as protective factors and rice (P = 0.008), bread (Ptrend = 0.04), liver (P = 0.004), butter (Ptrend = 0.04), white cheese (Ptrend < 0.0001), beef (Ptrend = 0.005), vegetable ghee (P < 0.0001) and, animal ghee (P = 0.015) remained as risk factors of lung cancer. Generally, we found positive trend between consumption of beef (P = 0.002), bread (P < 0.0001), and dairy products (P < 0.0001) with lung cancer. In contrast, only fruits were inversely related to lung cancer (P < 0.0001). CONCLUSION It seems that vegetables, fruits, and sunflower oil could be protective factors and bread, rice, beef, liver, dairy products, vegetable ghee, and animal ghee found to be possible risk factors for the development of lung cancer in Iran.
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Affiliation(s)
| | - Parisa Adimi Naghan
- Lung Transplantation Research Center, National Research and Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Shaheed Bahonar Ave, Darabad, Tehran 1955841452, Iran.
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Abstract
An estimated 16·5 million people worldwide illicitly use opiates, of whom 4 million use raw opium. We did a systematic review to investigate the association between opium use and cancer incidence and mortality. Opium use was associated with an increased risk of cancers of the oesophagus, stomach, larynx, lung, and urinary bladder. Although the present evidence suggests that these associations are possibly causal, further epidemiological studies (particularly prospective studies that collect detailed data about lifetime opium use and control for a broad range of potential confounders) are needed.
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Sadjadi A, Derakhshan MH, Yazdanbod A, Boreiri M, Parsaeian M, Babaei M, Alimohammadian M, Samadi F, Etemadi A, Pourfarzi F, Ahmadi E, Delavari A, Islami F, Farzadfar F, Sotoudeh M, Nikmanesh A, Alizadeh BZ, de Bock GH, Malekzadeh R. Neglected role of hookah and opium in gastric carcinogenesis: a cohort study on risk factors and attributable fractions. Int J Cancer 2014; 134:181-188. [PMID: 23797606 PMCID: PMC5821120 DOI: 10.1002/ijc.28344] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 05/30/2013] [Accepted: 06/03/2013] [Indexed: 01/01/2023]
Abstract
A recent study showed an association between hookah/opium use and gastric cancer but no study has investigated the relationship with gastric precancerous lesions. We examined the association between hookah/opium and gastric precancerous lesions and subsequent gastric cancer. In a population-based cohort study, 928 randomly selected, healthy, Helicobacter pylori-infected subjects in Ardabil Province, Iran, were followed for 10 years. The association between baseline precancerous lesions and lifestyle risk factors (including hookah/opium) was analyzed using logistic regression and presented as odds ratios (ORs) and 95% confidence intervals (CIs). We also calculated hazard ratios (HRs) and 95% CIs for the associations of lifestyle risk factors and endoscopic and histological parameters with incident gastric cancers using Cox regression models. Additionally, the proportion of cancers attributable to modifiable risk factors was calculated. During 9,096 person-years of follow-up, 36 new cases of gastric cancer were observed (incidence rate: 3.96/1,000 persons-years). Opium consumption was strongly associated with baseline antral (OR: 3.2; 95% CI: 1.2-9.1) and body intestinal metaplasia (OR: 7.3; 95% CI: 2.5-21.5). Opium (HR: 3.2; 95% CI: 1.4-7.7), hookah (HR: 3.4; 95% CI: 1.7-7.1) and cigarette use (HR: 3.2; 95% CI: 1.4-7.5), as well as high salt intake, family history of gastric cancer, gastric ulcer and histological atrophic gastritis and intestinal metaplasia of body were associated with higher risk of gastric cancer. The fraction of cancers attributable jointly to high salt, low fruit intake, smoking (including hookah) and opium was 93% (95% CI: 83-98). Hookah and opium use are risk factors for gastric cancer as well as for precancerous lesions. Hookah, opium, cigarette and high salt intake are important modifiable risk factors in this high-incidence gastric cancer area.
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Affiliation(s)
- Alireza Sadjadi
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Hatamabadi HR, Mahfoozpour S, Alimohammadi H, Younesian S. Evaluation of factors influencing knowledge and attitudes of mothers with preschool children regarding their adoption of preventive measures for home injuries referred to academic emergency centres, Tehran, Iran. Int J Inj Contr Saf Promot 2013; 21:252-9. [PMID: 23886078 DOI: 10.1080/17457300.2013.816325] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Excessive dependence of preschool children on their parents has led to a significant increase in the incidence of home injuries. Therefore, the present study aimed to evaluate factors influencing the knowledge and attitudes of mothers in this group regarding their adoption of preventive measures for home injuries. The subjects in this descriptive/analytical study consisted of all mothers of preschool children with home injuries, who had referred to the emergency department of Imam Hussein Hospital and Shohada-e-Haftome Tir Hospital in Tehran, Iran. After knowledge levels and attitudes of mothers were divided into two groups, multivariate logistic regression analysis and chi-squared test were used. Finally, 230 mothers, with a mean age of 29.4 ± 5.2 years, were evaluated, 75.0% of whom had good knowledge and 46.2% had positive attitudes. High school education, mothers' employment and mothers' absence from home for at least 8 hours a day were the factors predicting poor attitudes of mothers. There was a close correlation between mothers' knowledge and attitudes. The results of this study showed that mothers' high educational status, absence, occupation and the number of children in the family and history of accidents during the previous 3 weeks are important predicting factors.
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Affiliation(s)
- Hamid Reza Hatamabadi
- a Emergency Department , Shahid Beheshti University of Medical Sciences , Tehran , Iran
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Shakeri R, Malekzadeh R, Etemadi A, Nasrollahzadeh D, Aghcheli K, Sotoudeh M, Islami F, Pourshams A, Pawlita M, Boffetta P, Dawsey SM, Abnet CC, Kamangar F. Opium: an emerging risk factor for gastric adenocarcinoma. Int J Cancer 2013; 133:455-461. [PMID: 23319416 PMCID: PMC3644384 DOI: 10.1002/ijc.28018] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 12/05/2012] [Accepted: 12/06/2012] [Indexed: 12/11/2022]
Abstract
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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Affiliation(s)
- Ramin Shakeri
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD,USA
| | - Reza Malekzadeh
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD,USA
| | - Dariush Nasrollahzadeh
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Karim Aghcheli
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Gorgan University of Medical Sciences, Gorgan, Iran
| | - Masoud Sotoudeh
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Islami
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Institute for Translational Epidemiology and Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, USA
| | - Akram Pourshams
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Michael Pawlita
- Genome Modifications and Carcinogenesis Division, Infection and Cancer Program, German Cancer Research Center, Heidelberg, Germany
| | - Paolo Boffetta
- Institute for Translational Epidemiology and Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, USA
| | - Sanford M. Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD,USA
| | - Christian C. Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD,USA
| | - Farin Kamangar
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD,USA
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD
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