Adalberto MirandaFilho 1 Michelle C Turner 24 David B Richardson 15 Bayan Hosseini 1 Farin Kamangar 7 Akram Pourshams 6 Vikash Sewram 8 Saman Warnakulasuriya ID: 920898
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Slide1
The carcinogenicity of opium consumption: a meta-analysis
Adalberto Miranda-Filho1, Michelle C. Turner2-4, David B. Richardson1,5, Bayan Hosseini1, Farin Kamangar7, Akram Pourshams6, Vikash Sewram8, Saman Warnakulasuriya9, Mary K. Schubauer-Berigan1
Opium consumption was evaluated by a Working Group of the International Agency for Research on Cancer (IARC) Monographs programme and was classified as “carcinogenic to humans”.We aimed to build on the recent IARC evaluation of the carcinogenicity of opium consumption, by conducting a quantitative meta-analytic assess-ment of opium use related to risk of bladder, larynx, lung, pancreas, esophagus and stomach cancers.
1International Agency for Research on Cancer, Lyon, France, 2Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain, 3Universitat Pompeu Fabra (UPF), Barcelona, Spain, 4CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain, 5University of California, Irvine, California, USA, 6 Tehran University of Medical Science, Islamic Republic of Iran 7 Morgan State University, Maryland, USA, 8African Cancer Institute, South Africa,9 King’s College, London, UK
Slide2Methods
Searched in PubMed (using HAWC platform) and EMBASE.Meta-relative risks (mRRs) using random-effects modelsHeterogeneity using the I2 statistic. Assessment of study quality and sensitivity analyses according to the potential for bias and confoundingMeta-regression using a multivariable model was performed to investigate sensitivity of mRR estimates.
In total, 2 cohort studies and 29 case-control studies were included.
Slide3Results
mRR estimated for ‘ever’ compared with ‘never’ opium consumption ranged from 1.45 for cancer of the oesophagus to 7.89 for cancer of the larynx. Low level of heterogeneity, bladder and pancreas (I2=0%) and lung (I2=24%).Sensitivity analysis did not show important changes in mRR, (e.g., Bladder cancer)
Table 2. Results of the meta-analysis and sensitivity analyses for the risk of cancer and opium consumption.
Slide4Results and conclusion
Our findings support the rationale used for the IARC Monographs volume 126 Working Group, which classified opium consumption as carcinogenic to humans, with sufficient evi-dence for a causal association with cancers of the bladder, lung and larynx, and limited evidence for a causal association with cancers of stomach and esophagus. Exposure-effect model suggest high risk for higher exposure category