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Farhad Islami - One of the best experts on this subject based on the ideXlab platform.
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smoking water pipe Opium use and prevalence of heart disease a cross sectional analysis of baseline data from the pars cohort study southern iran
Archives of Iranian Medicine, 2020Co-Authors: Ali Adib, Reza Malekzadeh, Hossein Poustchi, Farhad Islami, Alireza Salehi, Seyed Masoom Masoompour, Hossein Molavi Vardanjani, Abdullah GondomkarAbstract:BackgroundAssociations between hookah and Opium use and an increased risk of ischemic heart disease (IHD) have been suggested in a few studies, but more research is needed on the nature of these associations. We aimed to investigate the association between hookah and Opium use and the prevalence of IHD in a population with relatively high prevalence of these exposures in Iran.MethodsUsing baseline data from the Pars Cohort Study (PCS), a prospective study of individuals aged 40-75 years in Fars province, southern Iran, we calculated adjusted and crude odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the independent association of hookah and Opium use with prevalence of IHD.ResultsOf 9248 participants, 10.2% (95% CI: 9.5, 10.9) had self-reported IHD. Prevalence of ever use of hookah and Opium was 48.9% (95% CI: 44.6, 53.6) and 10.2% (95% CI: 8.3, 12.5) among those with IHD, and 37.0% (95% CI: 35.7, 38.3) and 8.1% (95% CI: 7.5, 8.7) among those without IHD, respectively. Adjusted OR for the association with prevalence of IHD was 1.26 (95% CI: 1.08, 1.46) for hookah use and 1.71 (95% CI: 1.30, 2.24) for Opium abuse. No dose-response association was found between hookah and prevalence of IHD.ConclusionHookah and Opium abuse were associated with prevalent IHD in this study. Although more research is needed on these associations, particularly in prospective settings, reducing hookah and Opium use could potentially reduce IHD risk.
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Opium use and subsequent incidence of cancer results from the golestan cohort study
The Lancet Global Health, 2020Co-Authors: Mahdi Sheikh, A. Etemadi, Akram Pourshams, Hossein Poustchi, Masoud Khoshnia, Farhad Islami, Ramin Shakeri, Abdolsamad Gharavi, Gholamreza RoshandelAbstract:Summary 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 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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Opium use and risk of pancreatic cancer a prospective cohort study
Cancer Epidemiology Biomarkers & Prevention, 2017Co-Authors: Shirin Moossavi, Akram Pourshams, Hossein Poustchi, Mehdi Mohamadnejad, Farhad Islami, Maryam Sharafkhah, Babak Mirminachi, Siavosh Nasserimoghaddam, Shahryar Semnani, Ramin ShakeriAbstract: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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Opium use an emerging risk factor for cancer
Lancet Oncology, 2014Co-Authors: Farin Kamangar, Reza Malekzadeh, Farhad Islami, Ramin ShakeriAbstract: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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Opium an emerging risk factor for gastric adenocarcinoma
International Journal of Cancer, 2013Co-Authors: Ramin Shakeri, A. Etemadi, Reza Malekzadeh, Farhad Islami, Masoud Sotoudeh, Dariush Nasrollahzadeh, Karim AghcheliAbstract: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.
Ramin Shakeri - One of the best experts on this subject based on the ideXlab platform.
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Opium use and subsequent incidence of cancer results from the golestan cohort study
The Lancet Global Health, 2020Co-Authors: Mahdi Sheikh, A. Etemadi, Akram Pourshams, Hossein Poustchi, Masoud Khoshnia, Farhad Islami, Ramin Shakeri, Abdolsamad Gharavi, Gholamreza RoshandelAbstract:Summary 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 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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Opium use and risk of pancreatic cancer a prospective cohort study
Cancer Epidemiology Biomarkers & Prevention, 2017Co-Authors: Shirin Moossavi, Akram Pourshams, Hossein Poustchi, Mehdi Mohamadnejad, Farhad Islami, Maryam Sharafkhah, Babak Mirminachi, Siavosh Nasserimoghaddam, Shahryar Semnani, Ramin ShakeriAbstract: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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mortality from respiratory diseases associated with Opium use a population based cohort study
Thorax, 2017Co-Authors: Atieh Rahmati, H. Khademi, A. Etemadi, Akram Pourshams, Masoud Khoshnia, Amir Ali Sohrabpour, Ramin Shakeri, Hossein Poutschi, Ali AliasgariAbstract: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 (P trend Conclusions Long-term Opium use is associated with increased mortality from both malignant and non-malignant respiratory diseases.
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Opium use cigarette smoking and alcohol consumption in relation to pancreatic cancer
Medicine, 2016Co-Authors: Ramin Shakeri, Farin Kamangar, Mehdi Mohamadnejad, Masoud Sotoudeh, Reza Tabrizi, Farhad Zamani, Ashraf Mohamadkhani, Sepideh Nikfam, Arash Nikmanesh, Rasoul SotoudehmaneshAbstract: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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Opium use an emerging risk factor for cancer
Lancet Oncology, 2014Co-Authors: Farin Kamangar, Reza Malekzadeh, Farhad Islami, Ramin ShakeriAbstract: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.
A. Etemadi - One of the best experts on this subject based on the ideXlab platform.
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untargeted metabolomics biochemical perturbations in golestan cohort study Opium users inform intervention strategies
Frontiers in Nutrition, 2020Co-Authors: A. Etemadi, Hossein Poustchi, Reza Ghanbari, Wimal Pathmasiri, Susan Mcritchie, Amaneh Shayanrad, Gholamreza Roshandel, Jonathan D Pollock, Reza MalekzadehAbstract:Objective: Over 50 million people worldwide are estimated to use opioids, of which ~30 million use opiates (Opium and its derivatives). Use of opiates has been associated with a variety of adverse complications such as neurological and behavioral outcomes, addiction, cancers, diabetes, and cardiovascular disease. While it is well known that opiates exert their neurobiological effects through binding with mu, kappa, and delta receptors to exert analgesic and sedative effects, mechanistic links to other health effects are not well understood. Our study focuses on the identification of biochemical perturbations in Golestan Cohort Study (GCS) Opium users. Methods: We used untargeted metabolomics to evaluate the metabolic profiles of 218 Opium users and 80 non-users participating in the GCS. Urine samples were obtained from adult (age 40-75) Opium users living in the Golestan Province of Iran. Untargeted analysis of urine was conducted using a UPLC-Q-Exactive HFx Mass Spectrometry and a 700 MHz NMR Spectrometry. Results: These GCS Opium users had a significantly higher intake of tobacco and alcohol and a significantly decreased BMI compared with non-users. Metabolites derived from Opium (codeine, morphine, and related glucuronides), nicotine, and curing or combustion of plant material were increased in Opium users compared with non-users. Endogenous compounds which differentiated the Opium users and non-users largely included vitamins and co-factors, metabolites involved in neurotransmission, Kreb's cycle, purine metabolism, central carbon metabolism, histone modification, and acetylation. Conclusions: Our study reveals biochemical perturbations in GCS Opium users that are important to the development of intervention strategies to mitigate against the development of adverse effects of substance abuse.
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Opium use and subsequent incidence of cancer results from the golestan cohort study
The Lancet Global Health, 2020Co-Authors: Mahdi Sheikh, A. Etemadi, Akram Pourshams, Hossein Poustchi, Masoud Khoshnia, Farhad Islami, Ramin Shakeri, Abdolsamad Gharavi, Gholamreza RoshandelAbstract:Summary 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 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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mortality from respiratory diseases associated with Opium use a population based cohort study
Thorax, 2017Co-Authors: Atieh Rahmati, H. Khademi, A. Etemadi, Akram Pourshams, Masoud Khoshnia, Amir Ali Sohrabpour, Ramin Shakeri, Hossein Poutschi, Ali AliasgariAbstract: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 (P trend Conclusions Long-term Opium use is associated with increased mortality from both malignant and non-malignant respiratory diseases.
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neglected role of hookah and Opium in gastric carcinogenesis a cohort study on risk factors and attributable fractions
International Journal of Cancer, 2014Co-Authors: Alireza Sadjadi, Mohammad H Derakhshan, Abbas Yazdanbod, Majid Boreiri, Mahbubeh Parsaeian, Masoud Babaei, Masoomeh Alimohammadian, Fatemeh Samadi, A. EtemadiAbstract: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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Opium use and risk of mortality from digestive diseases a prospective cohort study
The American Journal of Gastroenterology, 2013Co-Authors: Masoud M Malekzadeh, H. Khademi, A. Etemadi, Akram Pourshams, Hossein Poustchi, Mohammad Bagheri, Masoud Khoshnia, Amir Ali Sohrabpour, Ali Aliasgari, E. JafariAbstract:RESULTS: In all, 8,487 (17 % ) participants reported Opium use, with a mean duration of 12.7 years. During the follow-up period 474 deaths from digestive diseases were reported (387 due to gastrointestinal cancers and 87 due to nonmalignant etiologies). Opium use was associated with an increased risk of death from any digestive disease (adjusted hazard ratio (HR) = 1.55, 95 % confi dence interval (CI) = 1.24 - 1.93). The association was dose dependent, with a HR of 2.21 (1.57 - 3.31) for the highest quintile of cumu- lative Opium use vs. no use ( P trend = 0.037). The HRs (95 % CI) for the associations between Opium use and malignant and nonmalignant causes of digestive mortality were 1.38 (1.07 - 1.76) and 2.60 (1.57 - 4.31), respectively. Increased risks were seen both for smoking Opium and for ingestion of Opium. CONCLUSIONS: Long-term Opium use, even in low doses, is associated with increased risk of death from both malignant and nonmalignant digestive diseases.
Akram Pourshams - One of the best experts on this subject based on the ideXlab platform.
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Opium use and subsequent incidence of cancer results from the golestan cohort study
The Lancet Global Health, 2020Co-Authors: Mahdi Sheikh, A. Etemadi, Akram Pourshams, Hossein Poustchi, Masoud Khoshnia, Farhad Islami, Ramin Shakeri, Abdolsamad Gharavi, Gholamreza RoshandelAbstract:Summary 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 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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Opium use and risk of pancreatic cancer a prospective cohort study
Cancer Epidemiology Biomarkers & Prevention, 2017Co-Authors: Shirin Moossavi, Akram Pourshams, Hossein Poustchi, Mehdi Mohamadnejad, Farhad Islami, Maryam Sharafkhah, Babak Mirminachi, Siavosh Nasserimoghaddam, Shahryar Semnani, Ramin ShakeriAbstract: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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mortality from respiratory diseases associated with Opium use a population based cohort study
Thorax, 2017Co-Authors: Atieh Rahmati, H. Khademi, A. Etemadi, Akram Pourshams, Masoud Khoshnia, Amir Ali Sohrabpour, Ramin Shakeri, Hossein Poutschi, Ali AliasgariAbstract: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 (P trend Conclusions Long-term Opium use is associated with increased mortality from both malignant and non-malignant respiratory diseases.
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Opium use and risk of mortality from digestive diseases a prospective cohort study
The American Journal of Gastroenterology, 2013Co-Authors: Masoud M Malekzadeh, H. Khademi, A. Etemadi, Akram Pourshams, Hossein Poustchi, Mohammad Bagheri, Masoud Khoshnia, Amir Ali Sohrabpour, Ali Aliasgari, E. JafariAbstract:RESULTS: In all, 8,487 (17 % ) participants reported Opium use, with a mean duration of 12.7 years. During the follow-up period 474 deaths from digestive diseases were reported (387 due to gastrointestinal cancers and 87 due to nonmalignant etiologies). Opium use was associated with an increased risk of death from any digestive disease (adjusted hazard ratio (HR) = 1.55, 95 % confi dence interval (CI) = 1.24 - 1.93). The association was dose dependent, with a HR of 2.21 (1.57 - 3.31) for the highest quintile of cumu- lative Opium use vs. no use ( P trend = 0.037). The HRs (95 % CI) for the associations between Opium use and malignant and nonmalignant causes of digestive mortality were 1.38 (1.07 - 1.76) and 2.60 (1.57 - 4.31), respectively. Increased risks were seen both for smoking Opium and for ingestion of Opium. CONCLUSIONS: Long-term Opium use, even in low doses, is associated with increased risk of death from both malignant and nonmalignant digestive diseases.
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Opium tobacco and alcohol use in relation to oesophageal squamous cell carcinoma in a high risk area of iran
British Journal of Cancer, 2008Co-Authors: D Nasrollahzadeh, Christian C Abnet, Akram Pourshams, Farin Kamangar, Farhad Islami, Ramin Shakeri, K Aghcheli, Masoud Sotoudeh, H A MarjaniAbstract:The very high incidence of oesophageal squamous cell carcinoma (ESCC) in Golestan Province in northeastern Iran was suggested by studies in the 1970s as partly due to Opium use, which is not uncommon in this area, but based on limited numbers. From December 2003 to June 2007, we administered a validated structured questionnaire to 300 ESCC cases and 571 controls, matched on neighbourhood of residence, age (±2 years), and sex. We used conditional logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) adjusted for potential confounders. Compared with those who used neither tobacco nor Opium, risk of ESCC was increased in those who used tobacco only (OR, 95% CI: 1.70, 1.05–2.73), in those who used Opium only (2.12, 1.21–3.74), and in those who used both tobacco and Opium (2.35, 1.50–3.67). All forms of tobacco use (cigarettes, hookah, and nass) were associated with higher ESCC risk. Similarly, use of both crude Opium and other forms of Opium were associated with higher risk. Alcohol consumption was seen in only 2% of the cases and 2% of the controls, and was not associated with ESCC risk.
Farin Kamangar - One of the best experts on this subject based on the ideXlab platform.
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fifty years of research and one conclusion Opium causes cancer
Archives of Iranian Medicine, 2020Co-Authors: Farin Kamangar, Mahdi Sheikh, Reza MalekzadehAbstract:In September 2020, the International Agency for Research on Cancer (IARC) announced that Opium consumption causes cancer in humans - a conclusion drawn after reviewing data from five decades of research. Given the widespread use of Opium and its derivatives by millions of people across the world, the classification of Opium consumption as a "Group 1" carcinogen has important public health ramifications. In this mini-review, we offer a short history of Opium use in humans and briefly review the body of research that led to the classification of Opium consumption as carcinogenic. We also discuss possible mechanisms of Opium's carcinogenicity and potential avenues for future research.
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Opium use cigarette smoking and alcohol consumption in relation to pancreatic cancer
Medicine, 2016Co-Authors: Ramin Shakeri, Farin Kamangar, Mehdi Mohamadnejad, Masoud Sotoudeh, Reza Tabrizi, Farhad Zamani, Ashraf Mohamadkhani, Sepideh Nikfam, Arash Nikmanesh, Rasoul SotoudehmaneshAbstract: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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Opium use an emerging risk factor for cancer
Lancet Oncology, 2014Co-Authors: Farin Kamangar, Reza Malekzadeh, Farhad Islami, Ramin ShakeriAbstract: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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Opium tobacco and alcohol use in relation to oesophageal squamous cell carcinoma in a high risk area of iran
British Journal of Cancer, 2008Co-Authors: D Nasrollahzadeh, Christian C Abnet, Akram Pourshams, Farin Kamangar, Farhad Islami, Ramin Shakeri, K Aghcheli, Masoud Sotoudeh, H A MarjaniAbstract:The very high incidence of oesophageal squamous cell carcinoma (ESCC) in Golestan Province in northeastern Iran was suggested by studies in the 1970s as partly due to Opium use, which is not uncommon in this area, but based on limited numbers. From December 2003 to June 2007, we administered a validated structured questionnaire to 300 ESCC cases and 571 controls, matched on neighbourhood of residence, age (±2 years), and sex. We used conditional logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) adjusted for potential confounders. Compared with those who used neither tobacco nor Opium, risk of ESCC was increased in those who used tobacco only (OR, 95% CI: 1.70, 1.05–2.73), in those who used Opium only (2.12, 1.21–3.74), and in those who used both tobacco and Opium (2.35, 1.50–3.67). All forms of tobacco use (cigarettes, hookah, and nass) were associated with higher ESCC risk. Similarly, use of both crude Opium and other forms of Opium were associated with higher risk. Alcohol consumption was seen in only 2% of the cases and 2% of the controls, and was not associated with ESCC risk.
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reliability and validity of opiate use self report in a population at high risk for esophageal cancer in golestan iran
Cancer Epidemiology Biomarkers & Prevention, 2004Co-Authors: Christian C Abnet, Mitra Saadatianelahi, Akram Pourshams, Paolo Boffetta, Ali Feizzadeh, Paul Brennan, Philip R Taylor, Farin Kamangar, Sanford M Dawsey, Reza MalekzadehAbstract:Objective: To assess the reliability and validity of self-reported Opium use in a rural Iranian population at high risk for esophageal cancer in preparation for a large cohort study. Method: 1,057 subjects ages 33 to 84 years were recruited from Gonbad city and three surrounding villages in Golestan province of Iran and completed a questionnaire and provided biological samples. The history and duration of using Opium, smoking tobacco, chewing nass, and drinking alcohol were measured by questionnaire in the entire cohort. A subgroup of 130 people was reinterviewed after 2 months to assess reliability. Validity of the Opium question was assessed by comparing the questionnaire responses with the presence of codeine and morphine in the urine of 150 selected subjects. Results: Self-reported opiate use is reliable and valid in this population. The reliability of ever Opium use and duration of Opium use had κ 's of 0.96 and 0.74, respectively. The validity of self-reported Opium use was also high. Using urine codeine or morphine as the gold standard for use of Opium, self-report had a sensitivity of 0.93 and a specificity of 0.89. Conclusions: The self-reported use of Opium can provide a reliable and valid measurement in this population and will be useful for studying associations between Opium use and occurrence of esophageal cancer and other diseases.
