Original Article

Can Opium Use Contribute to a Higher Risk of Colorectal Cancers? A Matched Case-control Study in Iran

Abstract

Background: Colorectal cancers (CRCs) including colon, rectum and anal cancers are the third most prevalent cancers in the world. There are strong evidence showing the risk of the cigarette smoking, alcohol use, low physical activity and some types of diets in CRCs; however, few studies explored the relationship between opium use and CRCs. This study aimed to investigate the association between opioid use and the incidence of CRCs.

Methods: In a population-based matched case-control study in Kerman, Iran, 175 patients with colorectal cancers and 350 healthy controls (matched for age, sex, and place of residence) were interviewed from Sep 2014 to Nov 2014. Opium and its derivatives, cigarette, alcohol, and diet use were collected using a valid and reliable questionnaire. Conditional logistic regression was used to estimate odds ratios with 95% confidence intervals.

Results: The use of opioids was associated with an increased risk of CRCs (adjusted odds ratio= 4. 5, 95% CI: 2. 4-8. 7). In addition, a dose-response relationship was observed between the cumulative use of opioids and the incidence of CRCs (with low use OR=3. 7; 95% CI: 1. 5-8. 6 and high use OR= 8. 0; 95% CI: 2. 9-21. 7). This dose-response relationship was also strong in patients with colon cancers, with OR= 3. 9 (95% CI: 1. 5-9. 9) and 9. 4 (95% CI: 3. 3-27. 0) for the low and high uses of opioids, respectively.

Conclusion: Opioid use can lead to an increased risk of CRCs. Therefore, it is necessary to implement preventive policies to control the use of opioids.

 

 

Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127 (12):2893-917.

Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011). Global cancer sta-tistics. CA Cancer J Clin, 61 (2):69-90.

Ansari R, Mahdavinia M, Sadjadi A, Nouraie M, Kamangar F, Bishehsari F, et al. (2006). Incidence and age distribution of colorectal cancer in Iran: results of a population-based cancer registry. Cancer Lett, 240 (1):143-7.

Mousavi SM, Gouya MM, Ramazani R, Da-vanlou M, Hajsadeghi N, Seddighi Z (2009). Cancer incidence and mortality in Iran. Ann Oncol, 20 (3):556-63.

Pourhoseingholi MA (2012). Increased bur-den of colorectal cancer in Asia. World J Gastrointest Oncol, 4 (4):68-70.

Malekzadeh R, Bishehsari F, Mahdavinia M, Ansari R (2009). Epidemiology and mo-lecular genetics of colorectal cancer in Iran: a review. Arch Iran Med, 12 (2):161-9.

Alireza S, Mehdi N, Ali M, Alireza M, Reza M, Parkin D (2005). Cancer occurrence in Iran in 2002, an international perspective. Asian Pac J Cancer Prev, 6 (3):359-63.

Barouni M, Larizadeh MH, Sabermahani A, Ghaderi H (2012). Markov's modeling for screening strategies for colorectal cancer. Asian Pac J Cancer Prev, 13 (10):5125-9.

Azadeh S, Moghimi-Dehkordi B, Fatem S, Pourhoseingholi M, Ghiasi S, Zali M (2008). Colorectal cancer in Iran: an epi-demiological study. Asian Pac J Cancer Prev, 9 (1):123-6.

Fazeli MS, Adel MG, Lebaschi AH (2007). Colorectal carcinoma: a retrospective, de-scriptive study of age, gender, subsite, stage, and differentiation in Iran from 1995 to 2001 as observed in Tehran Uni-versity. Dis Colon Rectum, 50 (7):990-5.

Bishehsari F, Mahdavinia M, Vacca M, Ma-lekzadeh R, Mariani-Costantini R (2014). Epidemiological transition of colorectal cancer in developing countries: environ-mental factors, molecular pathways, and opportunities for prevention. World J Gas-troenterol, 20 (20):6055-72.

Roya N, Abbas B (2013). Colorectal cancer trends in Kerman province, the largest province in Iran, with forecasting until 2016. Asian Pac J Cancer Prev, 14 (2):791-3.

Sadjadi A, Zahedi MJ, Nouraie M, Alimo-hammadian M, Ghorbani A, Bahmanyar S, et al. (2007). The first population-based cancer survey in Kerman Province of Iran. Iran J Public Health, 36 (4):26-34.

Parkin DM (2004). International variation. Oncogene, 23 (38):6329-40.

Chan D, Lau R, Aune D, Vieira R, Green-wood DC, Kampman E, et al. (2011). Red and processed meat and colorectal cancer incidence: meta-analysis of pro-spective studies. PloS One, 6 (6):e20456.

Chao A, Thun MJ, Connell CJ, McCullough ML, Jacobs EJ, Flanders WD, et al. (2005). Meat consumption and risk of colorectal cancer. JAMA, 293 (2):172-82.

Doubeni CA, Major JM, Laiyemo AO, Schootman M, Zauber AG, Hollenbeck AR, et al. (2012). Contribution of behav-ioral risk factors and obesity to socioeco-nomic differences in colorectal cancer in-cidence. J Natl Cancer Inst, 104 (18):1353-62.

Botteri E, Iodice S, Raimondi S, Mai-sonneuve P, Lowenfels AB (2008). Ciga-rette smoking and adenomatous polyps: a meta-analysis. Gastroenterology, 134 (2):388-95.

Doubeni CA, Laiyemo AO, Major JM, Schootman M, Lian M, Park Y, et al. (2012). Socioeconomic status and the risk of colorectal cancer: an analysis of over one-half million adults in the NIH-AARP Diet and Health Study. Cancer, 118 (14):3636-44.

Naghibzadeh Tahami A, Khanjani N, Yazdi Feyzabadi V, Varzandeh M, Haghdoost AA (2014). Opium as a risk factor for upper gastrointestinal cancers: a popula-tion-based case-control study in Iran. Arch Iran Med, 17 (1):2-6.

Akbari M, Naghibzadeh-Tahami A, Khanja-ni N, Baneshi MR, Kamali E, Hesampour M, et al. (2015). Opium as a Risk Factor for Bladder Cancer: A Population-based Case-control Study in Iran. Arch Iran Med, 18 (9):567-71.

Mousavi MRA, Damghani MA, Haghdoust AA, Khamesipour A (2003). Opium and risk of laryngeal cancer. The Laryngoscope, 113 (11):1939-43.

Masjedi MR, Naghan PA, Taslimi S, Youse-fifard M, Ebrahimi SM, Khosravi A, et al. (2013). Opium could be considered an independent risk factor for lung cancer: a case-control study. Respiration, 85 (2):112-8.

Shakeri R, Malekzadeh R, Etemadi A, Nasrollahzadeh D, Aghcheli K, Sotoudeh M, et al. (2013). Opium: an emerging risk factor for gastric adenocarcinoma. Int J Cancer, 133 (2):455-61.

Sadjadi A, Derakhshan MH, Yazdanbod A, Boreiri M, Parsaeian M, Babaei M, et al. (2014). Neglected role of hookah and opium in gastric carcinogenesis: A cohort study on risk factors and attributable fractions. Int J Cancer, 134 (1):181-8.

Ketabchi A, Gharaei M, Ahmadinejad M, Meershekari T (2005). Evaluation of bladder cancer in opium addicted patients in the Kerman Province, Iran, from 1999 to 2003. J Res Med Sci, 10 (6):355-7.

Hosseini SY, Safarinejad MR, Amini E, Hooshyar H (2010). Opium consumption and risk of bladder cancer: a case-control analysis. Urol Oncol , 28 (6):610-6.

Razmpa E, Saedi B, Motiee-langroudi M, Garajei A, Hoseinpor S, Motamedi MHK (2014). Opium Usage as an Etiologic Fac-tor of Oral Cavity Cancer. J Craniofac Surg, 25 (5):e505-e7.

Shakeri R, Kamangar F, Nasrollahzadeh D, Nouraie M, Khademi H, Etemadi A, et al. (2012). Is opium a real risk factor for esophageal cancer or just a methodologi-cal artifact? Hospital and neighborhood controls in case-control studies. PloS One, 7 (3):e32711.

Nasrollahzadeh D, Kamangar F, Aghcheli K, Sotoudeh M, Islami F, Abnet CC, et al (2008). Opium, tobacco, and alcohol use in relation to oesophageal squamous cell carcinoma in a high-risk area of Iran. Br J Cancer, 98 (11):1857-63.

Drugs UNOo (2010). World drug report. United Nations Publications.

Ziaaddini H, Ziaaddini MR (2005). The household survey of drug abuse in Ker-man. J Appl Sci, 5 (2):380-2.

Momtazi S, Rawson R. Substance abuse among Iranian high school students (2010). Curr Opin Psychiatry, 23 (3):221-6.

Nakhaee N, Divsalar K, Meimandi MS, Dabiri S (2008). Estimating the preva-lence of opiates use by unlinked anony-mous urine drug testing: a pilot study in Iran. Subst Use Misuse, 43 (3-4):513-20.

Cook-Mozaffari P, Azordegan F, Day N, Ressicaud A, Sabai C, Aramesh B (1979). Oesophageal cancer studies in the Caspi-an Littoral of Iran: results of a case-control study. Br J Cancer, 39 (3):293-309.

Aghaee-Afshar M, Khazaeli P, Behnam B, Rezazadehkermani M, Ashraf-Ganjooei N (2008). Presence of lead in opium. Arch Iran Med, 11 (5):553-4.

Amiri M, Amini R (2012). A comparison of bloodlead level (BLL) in opium-dependant addicts with healthy control group using the graphite furnace/atomic absorption spectroscopy (GF-AAS) fol-lowed by chemometric analysis. Iran Red Crescent Med J, 14 (8):488-91.

Rezaianzadeh A, Safarpour AR, Marzban M, Mohaghegh A (2015). A Systematic Re-view Over the Incidence of Colorectal Cancer in Iran. Ann Colorectal Res, 3 (1):e25724.

Abnet CC, Saadatian-Elahi M, Pourshams A, Boffetta P, Feizzadeh A, Brennan P, et al. (2004). Reliability and validity of opiate use self-report in a population at high risk for esophageal cancer in Golestan, Iran. Cancer Epidemiol Biomarkers Prev, 13 (6):1068-70.

Baeg MK, Choi M-G, Jung YD, Ko S-H, Lim C-H, Kim HH, et al. (2016). Esoph-ageal Squamous Cell Carcinoma Patients Have an Increased Risk of Coexisting Colorectal Neoplasms. Gut Liver, 10 (1):76-82.

Hewer T, Rose E, Ghadirian P, Castegnaro M, Malaveille C, Bartsch H, et al. (1978). Ingested mutagens from opium and to-bacco pyrolysis products and cancer of the oesophagus. Lancet, 2 (8088):494-6.

Friesen M, O'neill I, Malaveille C, Garren L, Hautefeuille A, Cabral J, et al. (1985). Characterization and identification of 6 mutagens in opium pyrolysates implicated in oesophagel cancer in Iran. Mutat Res, 150 (1):177-91.

Malekzadeh MM, Khademi H, Pourshams A, Etemadi A, Poustchi H, Bagheri M, et al. (2013). Opium use and risk of mortali-ty from digestive diseases: a prospective cohort study. Am J Gastroenterol, 108 (11):1757-65.

Perry P, Thomson E, Day N, Bartsch H (1983). Induction of SCE by opium py-rolysates in CHO cells and human pe-ripheral blood lymphocytes. Carcinogenesis, 4 (2):227-30.

Jung YS, Ryu S, Chang Y, Yun KE, Park JH, Kim HJ, et al. (2015). Risk factors for colorectal neoplasia in persons aged 30 to 39 years and 40 to 49 years. Gastrointest Endosc, 81 (3):637-45. e7.

Zisman AL, Nickolov A, Brand RE, Gor-chow A, Roy HK (2006). Associations between the age at diagnosis and location of colorectal cancer and the use of alco-hol and tobacco: implications for screen-ing. Arch Intern Med, 166 (6):629-34.

Norat T, Bingham S, Ferrari P, Slimani N, Jenab M, Mazuir M, et al. (2005). Meat, fish, and colorectal cancer risk: the Euro-pean Prospective Investigation into can-cer and nutrition. J Natl Cancer Inst, 97 (12):906-16.

Cross AJ, Ferrucci LM, Risch A, Graubard BI, Ward MH, Park Y, et al. (2010). A large prospective study of meat con-sumption and colorectal cancer risk: an investigation of potential mechanisms underlying this association. Cancer Res, 70 (6):2406-14.

Files
IssueVol 45 No 10 (2016) QRcode
SectionOriginal Article(s)
Keywords
Risk factor Colorectal cancers Opioid Case-control Iran

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
NAGHIBZADEH-TAHAMI A, YAZDI FEYZABADI V, KHANJANI N, ASHRAFI-ASGARABAD A, ALIZAEH H, BORHANINEJAD VR, MORADI-JOO M, ZEINALI M, ZAHEDI MJ, AGHAEE-AFSHAR M, HAGHDOOST AA. Can Opium Use Contribute to a Higher Risk of Colorectal Cancers? A Matched Case-control Study in Iran. Iran J Public Health. 2016;45(10):1322-1331.