阿片类药物使用与膀胱癌风险：伊朗的一项多中心病例对照研究。
Opium use and risk of bladder cancer: a multi-centre case-referent study in Iran.
机构信息
Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland.
Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Int J Epidemiol. 2022 Jun 13;51(3):830-838. doi: 10.1093/ije/dyac031.
BACKGROUND
Bladder cancer (BC) is the 10th most common type of cancer worldwide and the fourth most common type of cancer in Iran. Opium use is considered as one of the risk factors for BC. We aim to assess the association between various parameters of opium use, which in Iran is mainly ingested or smoked in various forms, and the risk of BC.
METHOD
In this multi-centre case-referent study in Iran, 717 BC cases and 3477 referents were recruited to the study from May 2017 until July 2020. Detailed histories of opium use (duration, amount, frequency) and potential confounders were collected by trained interviewers. Multivariable unconditional logistic regression models were used to measure adjusted odds ratio (OR) and 95% confidence intervals (CI). The ORs were adjusted for age, gender, place of residence and pack-years of cigarette smoking.
RESULTS
Regular opium consumption was associated with an increased risk of BC (OR 3.5, 95% CI: 2.8, 4.3) compared with subjects who never used opium. Compared with continuous users, the risk decreased to one-third for those who stopped opium more than 10 years ago. The adjusted OR for those who used both crude opium (teriak) and opium juice was 7.4 (95% CI: 4.1, 13.3). There was a joint effect of opium and tobacco (OR for users of both opium and tobacco 7.7, 95% CI: 6.0, 9.7).
CONCLUSIONS
Regular opium use is associated with an approximately 4-fold risk for BC. The OR decreases along with the increasing time since stopping opium use.
背景
膀胱癌（BC）是全球第 10 大常见癌症，也是伊朗第 4 大常见癌症。鸦片使用被认为是膀胱癌的危险因素之一。我们旨在评估伊朗主要以各种形式摄入或吸食的鸦片使用的各种参数与膀胱癌风险之间的关联。
方法
在伊朗的这项多中心病例对照研究中，我们于 2017 年 5 月至 2020 年 7 月招募了 717 名膀胱癌病例和 3477 名对照。由经过培训的访谈者收集鸦片使用（持续时间、数量、频率）和潜在混杂因素的详细病史。使用多变量非条件逻辑回归模型来测量调整后的比值比（OR）和 95%置信区间（CI）。OR 调整了年龄、性别、居住地和吸烟包年数。
结果
与从未使用过鸦片的受试者相比，经常吸食鸦片与膀胱癌的风险增加相关（OR 3.5，95%CI：2.8，4.3）。与连续使用者相比，10 年前以上停止吸食鸦片的风险降低至三分之一。使用粗鸦片（teriak）和鸦片汁的调整 OR 为 7.4（95%CI：4.1，13.3）。鸦片和烟草存在联合效应（同时使用鸦片和烟草的使用者的 OR 为 7.7，95%CI：6.0，9.7）。
结论
经常吸食鸦片与膀胱癌的风险增加约 4 倍相关。随着停止吸食鸦片时间的延长，OR 降低。
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