■鸦片消费最近被确定为致癌物质,但鸦片的使用对癌症负担的影响是未知的。我们旨在评估在广泛使用鸦片的地区,单独使用鸦片以及与吸烟结合使用的癌症比例。
■在2004年至2008年之间招募了50,045名伊朗成年人参加这项前瞻性队列研究,并随访至2022年1月。我们使用比例风险回归模型评估了使用鸦片和/或吸烟与各种癌症之间的关联。然后,我们计算了所有癌症以及与鸦片和吸烟有因果关系的癌症组的人口归因分数(PAF)。
■在所有参与者中,8%的人只使用鸦片,8.3%的人只吸烟,9%使用了这两种物质。在中位14年的随访中,2195人被诊断出患有癌症,包括215种与鸦片有关的癌症(肺癌,喉部,和膀胱)和1609烟草相关癌症(20种)。据估计,单独使用鸦片会导致35%(95%CI:26%-45%)的鸦片相关癌症,据估计,在该人群中,仅吸烟就会导致9%(6%-12%)的烟草相关癌症。据估计,使用鸦片和/或香烟会导致所有癌症的13%(9%-16%)。58%(49%-66%)与鸦片有关的癌症,和15%(11%-18%)的烟草相关癌症。此外,联合接触鸦片和香烟对喉癌的影响最大,咽部,肺,和膀胱,PAF范围从50%到77%。
■使用鸦片和吸烟在该人群中占很大比例的癌症。为了减轻癌症负担,预防政策应旨在通过公众宣传运动和干预努力来减少这两种药物的使用。
■Golestan队列研究工作由德黑兰医科大学资助,英国癌症研究中心,美国国家癌症研究所,国际癌症研究机构。提出的分析得到了国际HundredK+队列联合会(IHCC)的支持。
UNASSIGNED: Opium consumption has recently been identified as a carcinogen, but the impact of opium use on cancer burden is unknown. We aimed to evaluate the fraction of cancers that could be attributed to opium use alone and in combination with cigarette smoking in a region where opium is widely used.
UNASSIGNED: 50,045 Iranian adults were recruited to this prospective cohort
study between 2004 and 2008 and were followed through January 2022. We assessed the association between using opium and/or cigarette smoking and various cancers using proportional hazards regression models. We then calculated population attributable fractions (PAFs) for all cancers and for groups of cancers causally linked to opium and cigarette smoking.
UNASSIGNED: Of the total participants, 8% only used opium, 8.3% only smoked cigarettes, and 9% used both substances. During a median 14 years of follow-up, 2195 individuals were diagnosed with cancer, including 215 opium-related cancers (lung, larynx, and bladder) and 1609 tobacco-related cancers (20 types). Opium use alone was estimated to cause 35% (95% CI: 26%-45%) of opium-related cancers, while smoking cigarettes alone was estimated to cause 9% (6%-12%) of tobacco-related cancers in this population. Using opium and/or cigarettes was estimated to cause 13% (9%-16%) of all cancers, 58% (49%-66%) of opium-related cancers, and 15% (11%-18%) of tobacco-related cancers. Moreover, joint exposure to opium and cigarettes had the greatest impact on cancers of the larynx, pharynx, lung, and bladder, with PAFs ranging from 50% to 77%.
UNASSIGNED: Using opium and smoking cigarettes account for a large proportion of cancers in this population. To reduce the cancer burden, prevention policies should aim to decrease the use of both substances through public awareness campaigns and interventional efforts.
UNASSIGNED: The Golestan Cohort
Study work was funded by the Tehran University of Medical Sciences, Cancer Research UK, U.S. National Cancer Institute, International Agency for Research on Cancer. The presented analysis was supported by the International HundredK+ Cohorts Consortium (IHCC).