Mansouri Masoume, Sheidaei Ali, Poustchi Hossein, Roshandel Gholamreza, Malekzadeh Reza, Pourshams Akram, Sepanlou Sadaf G
Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Shariati Hospital, North Kargar Ave, Tehran, 14117-13135, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Sci Rep. 2025 Jul 2;15(1):22664. doi: 10.1038/s41598-025-06783-3.
Smoking and opium use are risk factors for gastrointestinal cancers, yet the extent to which cessation reduces cancer risk remains unclear, particularly in non-Western populations. This study analyzed data from the Golestan Cohort Study in northeastern Iran, comprising 50,045 adults aged 40-75 years followed for a median of 15 years. Participants were classified into never-users, current smokers or recent quitters (less than 5 years), and long-term quitters (more than 5 years). For esophageal cancer, long-term quitters demonstrated substantial risk reductions (HR for smoking: 0.68; 95% CI: 0.47-0.99; HR for opium: 0.33; 95% CI: 0.12-0.90), while current users and recent quitters of both smoking and opium indicated increased risks (HR for smoking: 1.53; 95% CI: 1.14-2.07; HR for opium: 1.50; 95% CI: 1.20-1.88). For stomach cancer, long-term smoking quitters showed a protective effect, with a 35% risk reduction though no significant risk reduction was observed for long-term opium cessation. For pancreatic cancer no significant risk reduction was noted among long-term quitters. This study highlights that cessation of smoking or opium use for more than 5 years can reduce the risk of esophageal cancer, while risk reduction for other types of gastrointestinal cancers requires longer cessation duration.
吸烟和使用鸦片是胃肠道癌症的风险因素，但戒烟能在多大程度上降低癌症风险仍不明确，尤其是在非西方人群中。本研究分析了伊朗东北部戈勒斯坦队列研究的数据，该研究包含50045名年龄在40 - 75岁的成年人，中位随访时间为15年。参与者被分为从不使用者、当前吸烟者或近期戒烟者（少于5年）以及长期戒烟者（超过5年）。对于食管癌，长期戒烟者的风险大幅降低（吸烟的风险比：0.68；95%置信区间：0.47 - 0.99；鸦片的风险比：0.33；95%置信区间：0.12 - 0.90），而吸烟和使用鸦片的当前使用者及近期戒烟者的风险则有所增加（吸烟的风险比：1.53；95%置信区间：1.14 - 2.07；鸦片的风险比：1.50；95%置信区间：1.20 - 1.88）。对于胃癌，长期戒烟者显示出保护作用，风险降低了35%，但长期戒除鸦片未观察到显著的风险降低。对于胰腺癌，长期戒烟者未观察到显著的风险降低。这项研究强调，戒烟或戒除鸦片超过5年可降低食管癌风险，而降低其他类型胃肠道癌症的风险则需要更长的戒除时间。
