Table 2.
Opium consumption and risk of various types of cancers in studies included in the present systematic review.
| First Author; Pub. year (Ref) | Cancer (type) | Cases (OU*/ NOU†) | Controls (OU*/ NOU†) | OR‡RR§HR¶ | Crude |
Minimally Adjusted model |
Fully Adjusted model |
|||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PE|| | CI⁎⁎ | PE|| | CI⁎⁎ | Ad factors | PE|| | CI⁎⁎ | Ad factors | |||||
| MacLennan, R; 1977 [48] | Lung | 233 (66/167) | 300 (32/268) |
OR | – | – | 3•3 | 2•08–5•26 | Age; Sex; Dialect | – | – | – |
| Sadeghi, A; 1979 [43] | Bladder | 99 (45/54) |
99 (8/91) |
OR | – | – | 9•47 | 4•15–21•60 | Age; Sex | – | – | – |
| " | Bladder | 99 (45/54) |
99 (8/91) |
RR | " | " | 2•7 | " | Age; Sex | " | " | " |
| Fahmy, MS; 1983 [75] | Lip and Oral cavity (upper/lower lips, cheek mucosa, gingiva and alveolar redge, floor of the mouth, tongue, and palate) | 381 (37/344) | 1000 (21/979) |
OR | – | – | 5•01 | 2•89–8•68 | Age, Socioeconomic status | – | – | – |
| Toutounchi, M.; 2000 [13] | Bladder | 142 (16/126) | 142 (7/135) |
OR | – | – | 2•44 | 0•97–6•14 | Age (±2 years); Sex | – | – | – |
| Mousavi, MR; 2003 [76] | Larynx (SCC) | 98 (23/75) | 312 (41/271) | OR | – | – | 2•02 | 1•14–3•58 | Age | 10•74 | 5•76–20•02 | Age; Sex; Duration of smoking (y); Number of cigarettes per day; Pack-years of smoking; Current smoking status |
| Aliasgari, M. A.; 2004 [42] | Bladder | 52 (13/39) | 108 (5/103) | OR | – | – | 6•86 | 2•29–20•53 | Age, Sex | – | – | – |
| Ketabchi, A.; 2005 [41] | Bladder | 112 (80/32) | 130 (31/99) | OR | – | – | 7•99 | 5•30–12•50 | Age, Sex | – | – | – |
| Nourbakhsh, A.; 2006 [40] | Bladder (TCC) | 255 (41/214) | 255 (12/243) | OR | 3•87 | 1•98–7•57 | – | – | – | – | – | – |
| Nasrollahzadeh, D.; 2008 [31] | Esophagus (SCC) | 300 (90/210) | 571 (106/465) | OR | – | – | 1•95 | 1•36–2•78 | Age (±2 years); Sex; Place of residence | 2 | 1•39–2•88 | Neighborhood of residence or village; Age (±2 years); Sex; Education; Ethnicity |
| Hosseini, S. Y; 2010 [39] | Bladder | 179 (60/119) | 179 (7/172) | OR | – | – | 12•38 | 5•47–28•04 | Age; Sex | 4•6 | 3•53–6•28 | Age; Sex; Cigarette smoking; Family history of cancer |
| Shakhssalim, N.; 2010 [38] | Bladder (TCC) | 692 (67/625) | 692 (20/672) | OR | – | – | 3•6 | 2•16–6•00 | Age (±5 years); Sex; Place of residence | 2•57 | 1•55–4•26 | Age (±5 years); Sex; Neighborhood of residence; Cigarette smoking |
| Masjedi, M. R.; 2013 [47] | Lung | 178 (51/127) | 356 (49/307) |
OR | – | – | 2•51 | 1•61–3•91 | Age (±3 years); Sex; Place of residence | – | – | – |
| Shakeri, R.; 2013 [25] | Gastric (Adenocarcinoma) | 309 (109/200) | 613 (131/482) |
OR | – | – | 2•3 | 1•6–3•2 | Age; Sex; Place of residence | 3•1 | 1•9–5•2 | Age; Sex; Place of residence; Ethnicity; Education; Fruit consumption; Vegetable consumption; Socioeconomic status; Cigarette, hookah and nass use |
| Shokri-Shirvani J.; 2013 [77] | Stomach | 281 (18/263) | 680 (43/637) |
OR | 1•01 | 0•57–1•79 | – | – | – | – | – | – |
| Hakami, R.; 2014 [28] | Esophagus (SCC) | 40 (13/27) |
80 (9/71) |
OR | – | – | 3•79 | 1•45–9•90 | Age (±5 years); Sex | – | – | – |
| Naghibzadeh Tahami, A.; 2014 [59] | Upper Gastrointestinal (UGI) (Oral cavity, stomach, esophagus, liver and pancreas) | 142 (54/88) | 284 (24/260) |
OR | – | – | 4•9 | 2•9–8•4 | Age; Sex; Place of residence | 4 | 2•2–7•0 | Age; Sex; Place of residence; Specific dietary factors such as consumption of meat, fruit and vegetable, hydrogenated fats, and other key exposure (Smoking) |
| " | Stomach | 89 (34/55) |
178 (17/161) |
OR | " | " | 3•9 | 2•9–6•8 | " | 3 | 1•6–5•6 | " |
| Razmpa, E.; 2014. [9] | Oral cavity | – | – | OR | – | – | 4 | 1•2–13•6 | Age; Sex; Socioeconomic status | – | – | – |
| Sadjadi, A.; 2014 [26] | Stomach | 36 (4/32) |
892 (14/878) |
HR | – | – | 4•6 | 1•6–13•3 | Age | 3•24 | 1•37–7•66 | Age; Sex; Family history of cancer; Cigarette smoking; Hookah smoking; Alcohol use; Fruit/vegetable intake; Salt intake |
| Akbari, M.; 2015 [37] | Bladder | 198 (43/155) | 396 (18/378) |
OR | – | – | 5•8 | 3•2–10•5 | Age; Sex; Place of residence | 3•9 | 1•3–12•0 | Age; Sex; Place of residence; Nutritional factors such as red meat, poultry, fish, hydrogenated oil, olive oil, butter intake, fat intake, fruits, nuts, and moldy food consumption; Alcohol and tobacco use |
| Aliramaji, A.; 2015 [36] | Bladder | 175 (58/117) | 175 (27/148) |
OR | – | – | 2•71 | 1•62–4•55 | Age; Sex | – | – | – |
| Ghadimi, T.; 2015 [35] | Bladder | 152 (16/136) | 152 (2/150) |
OR | – | – | 8•82 | 1•99–39•08 | Age (±5 years); Sex; Place of residence | 4•96 | 1•07–22•92 | Age (±5 years); Sex; Place of residence; Smoking history & status; Hypertension; Nephrolithiasis; Radiography; Education; BMI |
| Dianatinasab, M.; 2016 [33] | Colorectal | 220 (16/204) | – | HR | 2•49 | 1•41–4•42 | – | – | – | 2•8 | 1•5–4•63 | Age; Sex; BMI; Education; Ethnicity; Family history of cancer; Cancer grade; Smoking status; Type of lesion; Occupation; Monthly income |
| Lotfi, M. H.; 2016 [78] | Bladder | 199 (52/147) | 200 (21/179) |
OR | – | – | 3•01 | 1•73–5•23 | Age (±2 years); Sex; Place of residence | – | – | – |
| Naghibzadeh Tahami, A.; 2016 [32] | Colorectal (Colon, Rectum, and Anus) | 175 (45/130) | 350 (28/322) |
OR | – | – | 3•8 | 2•2–6•6 | Age; Sex; Place of residence | 4•5 | 2•4–8•7 | Age; Sex; Place of residence; Specific dietary factors such as the use of meat, fruit and vegetables, hydrogenated fats; Cigarette smoking |
| " | Colon | 142 (39/103) | 284 (26/258) |
OR | " | " | 3•7 | 2•1–6•6 | " | 5•7 | 2•7–11•9 | " |
| Shakeri, R.; 2016 [45] | Pancreas (Adenocarcinoma) | 357 (57/300) | 328 (21/307) |
OR | 2•77 | 1•64–4•69 | – | – | – | 1•91 | 1•06–3•43 | Age; Sex; Place of residence; Alcohol use; Ever use of any type of tobacco |
| Bakhshaee, M.; 2017 [12] | Larynx | 58 | 27 | OR | – | – | 9•09 | 3•21–25•64 | Age | 6•06 | 1•10–33•23 | Age; Smoking |
| " | Esophagus (SCC) |
98 | 27 | OR | " | " | 1•44 | 0•57–3•62 | Age | – | – | – |
| Lankarani, K. B.; 2017 [19] | Colorectal (Colon, Rectum, and Anus) |
160 (32/128) | 320 (16/304) |
OR | – | – | 4•37 | 2•33–8•22 | Age (±5 years); Sex; Place of residence | 4•48 | 2•27–8•82 | Age; Sex; Place of residence; Specific dietary factors such as consumption of meat, fruit and vegetable, hydrogenated fats, and other key exposure (Smoking) |
| " | Colon | 93 (18/75) |
186 (9/177) |
OR | " | " | 4•94 | 2•06–11•88 | " | 5•4 | 2•19–13•55 | " |
| Berjis, N.; 2018 [57] | Larynx (SCC) | 180 (101/79) | 180 (7/173) |
OR | 31•59 | 14•04–71•09 | – | – | – | 18•6 | 7•9–43•6 | Alcohol use; Smoking |
| Pournaghi, S. J.; 2019 [27] | Esophagus (SCC) | 96 (54/42) |
187 (76/111) |
OR | – | – | 1•87 | 1•14–3•08 | Age; Sex | – | – | – |
| Vazirinejad, R.; 2020 [58] | Gastrointestinal (Esophagus, Gastric, Pancreatic, and Colorectal) | 95 (25/70) |
190 (12/178) |
OR | – | – | – | – | – | 5•94 | 2•37–14•99 | Age; Sex; Place of residence; Smoking; Education; Family history of cancer; Consumption of red meat, fruit and vegetables |
| Alizadeh, H.; 2020 [79] | All Head and Neck cancers (Nasal cavity, paranasal sinuses, oral cavity, pharynx, larynx, and salivary glands cancers) | 140 (98/42) |
280 (75/205) |
OR | – | – | 11•82 | 6•07- 23•0 | Age (±5 years); Sex; Place of residence | 8•13 | 4•08- 16•21 | Age (±5 years); Sex; Place of residence; Specific dietary factors such as the use of meat, fruit and vegetables, hydrogenated fats, olive oil; Education |
| " | Larynx | 111 (88/23) |
222 (64/158) |
OR | " | " | 17•52 | 7•56–40•60 | " | 11•98 | 5•05–28•39 | " |
| Naghibzadeh Tahami, A.; 2020 [80] | Lung | 140 (83/57) |
280 (55/225) |
OR | – | – | 9•73 | 5•21–18•15 | Age (±5 years); Sex; Place of residence | 5•95 | 1•87–18•92 | Age (±5 years); Sex; Place of residence; Specific dietary factors such as the use of meat, fruit and vegetables, hydrogenated fats, olive oil; Alcohol consumption; Ciggarette smoking; Education |
| Sheikh, M.; 2020 [55] | All cancers | 1833 | Cohort: 50,034 | HR | – | – | – | – | – | 1•4 | 1•24–1•58 | Sex, ethnicity (Turkman vs non-Turkman), residence (urban vs rural), wealth score quartiles, smoking cigarettes (in the subgroups of tobacco users and entire cohort, fitted as ever vs never), cumulative pack-years of smoked cigarettes, and regular alcohol drinking (ever vs never). |
| " | Gastrointestinal | 914 | Cohort: 50,034 | HR | " | " | " | " | " | 1•31 | 1•11–1•55 | " |
| " | Respiratory | 154 | Cohort: 50,034 | HR | " | " | " | " | " | 2•28 | 1•58–3•30 | " |
| " | Esophagus | 342 | Cohort: 50,034 | HR | " | " | " | " | " | 1•38 | 1•06–1•80 | " |
| " | Stomach | 318 | Cohort: 50,034 | HR | " | " | " | " | " | 1•36 | 1•03–1•79 | " |
| " | Lung | 116 | Cohort: 50,034 | HR | " | " | " | " | " | 2•21 | 1•44–3•39 | " |
| " | Colon | 95 | Cohort: 50,034 | HR | " | " | " | " | " | 0•9 | 0•48–1•67 | " |
| " | Brain | 80 | Cohort: 50,034 | HR | " | " | " | " | " | 1•13 | 0•61–2•09 | " |
| " | Pancreas | 78 | Cohort: 50,034 | HR | " | " | " | " | " | 1•54 | 0•87–2•72 | " |
| " | Liver | 75 | Cohort: 50,034 | HR | " | " | " | " | " | 1•22 | 0•68–2•18 | " |
| " | Bladder | 47 | Cohort: 50,034 | HR | " | " | " | " | " | 2•86 | 1•47–5.55 | " |
| " | Larynx | 38 | Cohort: 50,034 | HR | " | " | " | " | " | 2•53 | 1•21–5•29 | " |
| Mohebbi, M.; 2020 [81] | Head and Neck SCCs (Lips, oral cavity, pharynx, larynx, and some other sub-sites) | 663 (295/368) | 3065 (401/2664) | OR | – | – | 5•33 | 4•42–6•41 | Age; Sex; Place of residence | 3•76 | 2•96–4•79 | Age; Sex; Place of residence; Pack-years of cigarette smoking; Head-years of water-pipe smoking; Regular alcohol drinking; Socioeconomic status, Oral health (DMF index) |
| " | Lip and Oral cavity | 254 (33/221) | 3065 (401/2664) | OR | " | " | 0•99 | 0•68–1•45 | " | 1•53 | 0•97–2•41 | " |
| " | Pharynx | 54 (17/37) | 3065 (401/2664) | OR | " | " | 3•05 | 1•70–5•47 | " | 2•90 | 1•40–6•02 | " |
| " | Larynx | 327 (231/96) | 3065 (401/2664) | OR | " | " | 15•99 | 12•32–20•73 | " |
6•55 | 4•69–9•13 | " |
⁎
OU: Opium users;.
†
NOU: Non opium users;.
‡
OR: Odds ratio;.
§
RR: Relative risk;.
¶
HR: Hazard ration;.
||
PE: Point estimate;.
⁎⁎
CI: Confidence interval.