Bidary Mohammad Zamiri, Sahranavard Mehrdad, Rezayat Arash Akhavan, Omranzadeh Alireza, Hoseiny Seyyed Hasan, Kabirian Ali, Sahebkar Amirhossein
Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
EClinicalMedicine. 2021 Feb 24;33:100768. doi: 10.1016/j.eclinm.2021.100768. eCollection 2021 Mar.
Opium 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.
Four 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.
34 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.
Opium consumption is highly associated with all reported types of cancers, especially in fully adjusted model; however, basic pathophysiology should be further investigated.
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通过在不同身体系统中进行的多项研究，鸦片及其热解产物已被作为潜在致癌物质进行调查；然而，结果存在争议，在这方面未达成共识。因此，我们旨在系统回顾和荟萃分析所有关于鸦片消费与癌症之间关联的现有证据。
对包括ISI Web of Science、PubMed、Scopus和Embase以及Magiran和SID在内的四个主要电子数据库进行全面检索，以查找从数据库建立到2020年9月25日发表的所有文章。所有研究均通过纽卡斯尔渥太华量表（NOS）清单进行严格评估。提取所选研究的相关人口统计学数据和预期结果，并使用综合荟萃分析（CMA）汇总其优势比（OR）。计算鸦片导致不同癌症的累积风险。
34项研究（共18230名个体）纳入我们的系统回顾，最终32篇出版物纳入荟萃分析。总体而言，使用随机效应模型，在最小调整[OR = 4.14，95%CI =（3.32 - 5.15）]和完全调整[OR = 4.35，95%CI =（3.36 - 5.62）]分析中，鸦片消费均与恶性肿瘤发生率增加相关。此外，使用随机效应完全调整模型，亚组分析显示，与非消费者相比，鸦片消费者患喉癌[OR = 9.58，95%CI =（6.31 - 14.53）]、呼吸道癌[OR = 9.02，95%CI =（6.27 - 12.96）]、头颈癌[OR = 8.03，95%CI =（4.03 - 16.00）]和结肠癌[OR = 5.58，95%CI =（3.14 - 9.92）]的风险增加。
鸦片消费与所有报告类型的癌症高度相关，尤其是在完全调整模型中；然而，基本病理生理学仍需进一步研究。
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