Abstract
BackgroundOpium 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.MethodsFour 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.Findings34 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.InterpretationOpium consumption is highly associated with all reported types of cancers, especially in fully adjusted model; however, basic pathophysiology should be further investigated.FundingNone.
Highlights
Cancer is the second leading cause of death and is responsible for one out of every six mortality cases, globally [1]
Which cancers are more associated with opium addiction? The current study has been conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement [50]
Our results were highly suggestive of opium carcinogenicity in different parts of the body
Summary
Cancer is the second leading cause of death and is responsible for one out of every six mortality cases, globally [1]. Opium may be among these risk factors and controversial studies have been conducted pro [9,10,11] and against [12,13] its carcinogenicity. Overall, using the random effects model, opium consumption was associated with increased rate of malignancies in both minimally[OR = 4.14 95%CI = (3.32À5.15)] and fully adjusted [OR = 4.35 95%CI = (3.36À5.62)] analyses. Using random effects fully adjusted model, the subgroup analysis revealed increased risk for larynx [OR = 9.58 95%CI = (6.31À14.53)], respiratory [OR = 9.02 95%CI = (6.27À12.96)], head and neck [OR = 803 95%CI = (4.03À16.00)], and colon [OR=5.58 95%CI = (3.14À9.92)] 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; basic pathophysiology should be further investigated.
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