Table 4.
Routes of using opium and risk of different cancer types
| Never used opium (n=41 548) | Only smoked opium (n=5810) | Only ingested opium (n=2156) | Both routes (n=520) | ||
|---|---|---|---|---|---|
| All cancers combined | |||||
| n (%) | 1351 (73·7%) | 281 (15·3%) | 160 (8·7%) | 41 (2·2%) | |
| Entire cohort (n=1833)* | 1 (ref) | 1·32 (1·15–1·52) | 1·49 (1·25–1·78) | 1·71 (1·24–2·36) | |
| Never used tobacco (n=1361)† | 1 (ref) | 1·34 (1·11–1·61) | 1·24 (0·94–1·63) | 1·68 (0·95–2·98) | |
| Ever used tobacco (n=472)‡ | 1 (ref) | 1·32 (1·06–1·64) | 1·79 (1·39–2·30) | 1·76 (1·18–2·64) | |
| Gastrointestinal cancers combined | |||||
| n (%) | 672 (73·5%) | 143 (15·6%) | 80 (8·8%) | 19 (2·1%) | |
| Entire cohort (n=914)* | 1 (ref) | 1·28 (1·05–1·56) | 1·33 (1·04–1·70) | 1·48 (0·93–2·37) | |
| Never used tobacco (n=685)† | 1 (ref) | 1·35 (1·05–1·74) | 0·95 (0·63–1·42) | 2·08 (1·07–4·03) | |
| Ever used tobacco (n=229)‡ | 1 (ref) | 1·18 (0·86–1·62) | 1·71 (1·21–2·43) | 1·18 (0·60–2·29) | |
| Respiratory cancers combined | |||||
| n (%) | 74 (48·1%) | 44 (28·6%) | 27 (17·5%) | 9 (5·8%) | |
| Entire cohort (n=154)* | 1 (ref) | 2·05 (1·35–3·10) | 2·61 (1·60–4·26) | 3·08 (1·46–6·49) | |
| Never used tobacco (n=59)† | 1 (ref) | 2·16 (1·00–4·65) | 1·69 (0·51–5·53) | 3·36 (0·45–24·69) | |
| Ever used tobacco (n=95)‡ | 1 (ref) | 2·06 (1·24–3·44) | 2·84 (1·60–5·04) | 3·02 (1·32–6·91) | |
| Oesophageal cancer | |||||
| n (%) | 249 (72·8%) | 55 (16·1%) | 29 (8·5%) | 9 (2·6%) | |
| Entire cohort (n=342)* | 1 (ref) | 1·43 (1·04–1·95) | 1·20 (0·79–1·82) | 1·95 (0·98–3·87) | |
| Never used tobacco (n=266)† | 1 (ref) | 1·58 (1·08–2·30) | 0·90 (0·47–1·69) | 2·34 (0·86–6·31) | |
| Ever used tobacco (n=76)‡ | 1 (ref) | 1·19 (0·69–2·07) | 1·57 (0·85–2·89) | 1·69 (0·64–4·46) | |
| Gastric cancer | |||||
| n (%) | 218 (70·8%) | 56 (18·2%) | 28 (9·1%) | 6 (1·9%) | |
| Entire cohort (n=308)* | 1 (ref) | 1·41 (1·03–1·93) | 1·30 (0·83–1·97) | 1·28 (0·54–2·92) | |
| Never used tobacco (n=255)† | 1 (ref) | 1·39 (0·92–2·11) | 0·96 (0·49–1·90) | 1·21 (0·30–4·92) | |
| Ever used tobacco (n=83)‡ | 1 (ref) | 1·53 (0·91–2·57) | 1·65 (0·91–2·99) | 1·36 (0·47–3·93) | |
| Lung cancer | |||||
| n (%) | 59 (50·9%) | 30 (25·9%) | 20 (17·2%) | 7 (6·0%) | |
| Entire cohort (n=116)* | 1 (ref) | 1·90 (1·17–3·10) | 2·66 (1·51–4·68) | 3·27 (1·40–4·64) | |
| Never used tobacco (n=49)† | 1 (ref) | 1·84 (0·77–4·41) | 1·27 (0·30–5·36) | .. | |
| Ever used tobacco (n=67)‡ | 1 (ref) | 2·12 (1·13–3·96) | 3·37 (1·70–6·69) | 4·13 (1·65–10·37) | |
| Colon cancer | |||||
| n (%) | 80 (84·2%) | 10 (10·5%) | 5 (5·3%) | 0 | |
| Entire cohort (n=95)* | 1 (ref) | 0·88 (0·43–1·79) | 1·14 (0·44–2·96) | .. | |
| Never used tobacco (n=75)† | 1 (ref) | 1·03 (0·40–2·61) | 1·04 (0·26–4·33) | .. | |
| Ever used tobacco (n=20)‡ | 1 (ref) | 0·66 (0·22–1·93) | 1·26 (0·33–4·77) | .. | |
| Brain cancer | |||||
| n (%) | 64 (80·0%) | 7 (8·8%) | 9 (11·3%) | 1 (1·3%) | |
| Entire cohort (n=80)* | 1 (ref) | 0·71 (0·31–1·64) | 2·15 (1·00–4·63) | 1·05 (0·14–7·90) | |
| Never used tobacco (n=61)† | 1 (ref) | 0·97 (0·35–2·72) | 1·76 (0·54–5·72) | .. | |
| Ever used tobacco (n=19)‡ | 1 (ref) | 0·49 (0·13–1·86) | 2·45 (0·82–7·34) | 1·40 (0·17–11·50) | |
| Pancreatic cancer | |||||
| n (%) | 47 (70·1%) | 12 (17·9%) | 6 (8·9%) | 2 (2·9%) | |
| Entire cohort (n=78)* | 1 (ref) | 1·60 (0·84–3·05) | 1·34 (0·54–3·28) | 1·99 (0·46–8·54) | |
| Never used tobacco (n=56)† | 1 (ref) | 1·63 (0·68–3·87) | 0·54 (0·07–3·98) | 3·34 (0·45–24·45) | |
| Ever used tobacco (n=22)‡ | 1 (ref) | 1·67 (0·61–4·59) | 2·09 (0·65–6·77) | 1·57 (0·18–13·03) | |
| Liver cancer | |||||
| n (%) | 53 (72·6%) | 8 (11·0%) | 12 (16·4%) | 0 | |
| Entire cohort (n=73)* | 1 (ref) | 0·78 (0·35–1·71) | 2·46 (1·23–4·95) | .. | |
| Never used tobacco (n=49)† | 1 (ref) | 1·09 (0·38–3·09) | 1·80 (0·54–5·92) | .. | |
| Ever used tobacco (n=24)‡ | 1 (ref) | 0·48 (0·15–1·54) | 2·50 (0·99–6·35) | .. | |
| Bladder cancer | |||||
| n (%) | 24 (51·0%) | 13 (27·7%) | 9 (19·1%) | 1 (2·1%) | |
| Entire cohort (n=47)* | 1 (ref) | 2·56 (1·21–5·40) | 3·79 (1·61–8·88) | 1·66 (0·21–13·02) | |
| Never used tobacco (n=26)† | 1 (ref) | 3·22 (1·15–9·01) | 6·27 (2·01–19·55) | .. | |
| Ever used tobacco (n=21)‡ | 1 (ref) | 1·78 (0·62–5·04) | 2·13 (0·64–7·06) | 1·48 (0·17–12·66) | |
| Laryngeal cancer | |||||
| n (%) | 15 (39·5%) | 14 (36·8%) | 7 (18·4%) | 2 (5·3%) | |
| Entire cohort (n=38)* | 1 (ref) | 2·54 (1·14–5·68) | 2·48 (0·93–6·62) | 2·61 (0·55–12·41) | |
| Never used tobacco (n=10)† | 1 (ref) | 4·52 (0·86–23·67) | 4·92 (0·55–44·04) | 31·03 (3·44–279·31) | |
| Ever used tobacco (n=28)‡ | 1 (ref) | 1·94 (0·80–4·71) | 1·84 (0·63–5·37) | 1·00 (0·12–8·36) | |
Data are hazard ratio (95% CI), unless otherwise indicated.
*
This model used age as the timescale and was adjusted for sex, ethnicity (Turkman vs non-Turkman), residence (urban vs rural), wealth score quartiles, smoking cigarettes (ever vs never), cumulative pack-years of smoked cigarettes (continuous variable), and regular alcohol drinking (never vs ever).
†
This model used age as the timescale and was adjusted for sex, ethnicity (Turkman vs non-Turkman), residence (urban vs rural), wealth score quartiles, and regular alcohol drinking (never vs ever).
‡
This model used age as the timescale and was adjusted for sex, ethnicity (Turkman vs non-Turkman), residence (urban vs rural), wealth score quartiles, cumulative pack-years of smoked cigarettes (continuous variable), and regular alcohol drinking (never vs ever).