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Publications

Journal Article Ahead of print

PubMed: 42671160 DOI: 10.1158/1055-9965.EPI-26-0662

Tobacco and opium use and risk of liver and colorectal cancer mortality: Analysis of the Golestan Cohort Study (GCS).

Cancer Epidemiol Biomarkers Prev

Authors: Hao Larissa Wang, Monireh Sadat Seyyedsalehi, Hossein Poustchi, Mahdi Sheikh, Akram Pourshams, Farin Kamangar, Christian C Abnet, Arash Etemadi, Reza Malekzadeh, Paolo Boffetta

Affiliations

  • Icahn School of Medicine at Mount Sinai New York United States.
  • University of Bologna Italy.
  • Tehran University of Medical Sciences Tehran Iran.
  • Centre international de recherche sur le cancer Lyon France.
  • Morgan State University Baltimore, MD United States.
  • National Cancer Institute Rockville, MD United States.
  • National Cancer Institute Bethesda, MD United States.
  • Tehran University of Medical Sciences Tehran, Tehran Iran.

Abstract

BACKGROUND

Tobacco and opium consumption are prevalent in Iran and have been linked to increased risk of upper GI cancers. To investigate their role in lower GI cancers, the associations of tobacco and opium use with liver and colorectal cancer mortality were examined in this study.

METHODS

From 2004-2008, participants aged 40 to 75 years were recruited through random systematic cluster sampling and primary healthcare worker contact in Golestan, Iran. Baseline assessment of tobacco and opium use, demographic information and cancer-relative risk factors were conducted through validated questionnaires. Cancer diagnoses and deaths were collected through regular follow-up between 2004 and March 6, 2023. Multivariate Cox proportional regression model evaluated the association between tobacco and opium use and liver and colorectal cancer mortality.

RESULTS

During a median 15 years of follow up, 112 participants developed liver cancer and 201 developed colorectal cancer. Cigarette smoking (hazard ratio [HR] = 1.76, 95% confidence interval [CI] 1.05, 2.94) and water-pipe smoking (HR = 3.20, 95% CI 1.12, 9.13) were associated with liver cancer. Opium was not associated with liver cancer. We observed no associations between tobacco or opium use and risk of colorectal cancer.

CONCLUSIONS

Cigarette and water-pipe smoking were associated with increased liver cancer mortality, whereas no significant associations were observed for tobacco and opium use and colorectal cancer mortality.

IMPACT

Tobacco control could be a strategy for reducing liver cancer mortality in high-risk populations. Larger prospective studies are required to confirm the associations of tobacco and opium use with lower GI cancers.

MeSH

Mortality, Opium, Neoplasms, Cohort Studies, Liver, Liver Neoplasms, Colorectal Neoplasms, Smoking, Pipe Smoking, Opium Dependence