Opium use, cigarette smoking, and alcohol consumption in relation to pancreatic cancer

Shakeri, Ramin; Kamangar, Farin; Mohamadnejad, Mehdi; Tabrizi, Reza; Zamani, Farhad; Ashraf, Muhammad; Nikfam, Sepideh; Nikmanesh, Arash; Sotoudeh, Masoud; Sotoudehmanesh, Rasoul; Shahbazkhani, Bijan; Ostovaneh, Mohammad Reza; Islami, Farhad; Boffetta, Paolo; Malekzadeh, Reza; Pourshams, Akram

doi:10.1097/md.0000000000003922

Cited by 54 publications

(81 citation statements)

References 32 publications

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“…Although, cigarette smoking is associated with higher risk of pancreatic cancer in our population; further controlling for opium consumption, we found that cigarette smoking or opium consumption alone were not statistically significantly associated with higher risk of pancreatic cancer which is in accordance with our previous case-control study (23). However, high dose opium use was associated with pancreatic cancer when we tightly controlled for cigarette smoking.…”

Section: Discussionsupporting

confidence: 92%

“…morphine) on the peristalsis of the intestinal tract (21, 22). We recently observed a higher risk of pancreatic cancer for opium ever users in a case-control study (23). Therefore, our objective was to further investigate our preliminary results on the association of opium consumption as a risk factor with pancreatic cancer incidence in a population-based prospective cohort.…”

Section: Introductionmentioning

confidence: 99%

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Opium Use and Risk of Pancreatic Cancer: A Prospective Cohort Study

Moossavi

Mohamadnejad

Pourshams

et al. 2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background We examined the association between opium consumption and pancreatic cancer incidence in a large-scale prospective cohort of the general population in Northeast of 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 hazard ratios (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 to 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]. Conclusion 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.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Opium Use and Risk of Pancreatic Cancer: A Prospective Cohort Study

Moossavi

Mohamadnejad

Pourshams

et al. 2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Individuals with the highest cumulative opium use had the strongest association . Opium use was also associated with an increased risk of pancreatic cancer …”

Section: Discussionmentioning

confidence: 96%

“…24 Opium use was also associated with an increased risk of pancreatic cancer. 25 The possible carcinogenic effect of opioids was further investigated in a completely different population, oncologic patients receiving pain-relieving opiates. Previous studies suggested that intraoperative administration of opioids in oncologic patients might be associated with recurrence.…”

Section: Discussionmentioning

confidence: 99%

Intravenous opioid drug abuse as an independent risk factor for supraglottic squamous cell carcinoma—A case‐control study

Shoffel‐Havakuk

Cohen

Slavin

et al. 2017

Clinical Otolaryngology

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“…In the GCS, for example, the adjusted HR for opium and mortality was 1.86, whereas the adjusted for smoking and mortality was <1.30 36. In case-control studies in the 1970s,37 as well as in more recent case-control studies, tobacco smoking increased the risk of oesophageal squamous cell carcinom (OSCC) less than twofold,17 was not associated with increased risk of gastric cancer38 and was not associated with risk of pancreatic cancer 39. We also see a relatively weak HR for lung cancer.…”

Section: Discussionmentioning

confidence: 98%

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

Rahmati

Shakeri

Khademi

et al. 2016

Thorax

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

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Opium use, cigarette smoking, and alcohol consumption in relation to pancreatic cancer

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Cited by 54 publications

References 32 publications

Opium Use and Risk of Pancreatic Cancer: A Prospective Cohort Study

Opium Use and Risk of Pancreatic Cancer: A Prospective Cohort Study

Intravenous opioid drug abuse as an independent risk factor for supraglottic squamous cell carcinoma—A case‐control study

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

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