Opium Usage and Risk of Head and Neck Cancer: A Systematic Review and Meta-Analysis.

Garima Singh,Akhil Goel,Pankaja Raghav,Abhishek Jaiswal

doi:10.31557/apjcp.2021.22.3.661

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.

Highlights

Opium is among the most used substance of abuse worldwide
Pooled estimate of odds ratio (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
In this systematic review and meta-analysis, we aimed to find the association between opium use or abuse and head and neck cancer

Summary

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. This study aimed to find the association between opium use or abuse and head and neck cancer. 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. Pooled odds ratio for risk of cancer among opium users for the 11-case control study was 3.85 (2.18-6.79). Illegal drug use is a worldwide phenomenon, which has drastic effects on public health. Opium use or abuse leads to several acute health hazards and some reports states association between use long term effects of opium use and risk of cancer. (“American Cancer Society | Information and Resources about for Cancer,” 2019) Many experiments and case control studies have explored the carcinogenic effects of long term use of opium. Link between opium and oral, bladder, lung, head and neck and gastric cancers have been found in past studies. (“American Cancer Society | Information and Resources about for Cancer,” 2019) Many experiments and case control studies have explored the carcinogenic effects of long term use of opium. (Sheikh et al, 2020)

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