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Review
. 2024;17(2):104-120.

Opium use and gastrointestinal cancers: a systematic review and meta-analysis study

Mahsa Mohammadi  1 , Philippe Tadger  2 , Amir Sadeghi  3 , Niloufar Salehi  3 , Mohsen Rajabnia  4 , Elham Paraandavaji  3   5 , Sasan Shafiei  3   5 , Ahmad Pirani  6 , Mohammad Reza Hatamnejad  3 , Erfan Taherifard  7 , Fatemeh Kheshti  7 , Arman Naderilordejani  3 , Forough Honarfar  3 , Khaled Rahmani  3 , Majid Soruri  3 , Hamed Kord Varkaneh  3 , Omid Dadras  8   9 , Ali Jahanian  3 , Sara Rasta  4 , Mohammad Reza Zali  3
Affiliations
Review

Opium use and gastrointestinal cancers: a systematic review and meta-analysis study

Mahsa Mohammadi et al. Gastroenterol Hepatol Bed Bench. 2024.

Abstract

Aim: The current systematic review and meta-analysis aimed to assess the association between Gastrointestinal (GI) cancers and opium use.

Background: GI malignancies are a global public health issue and are associated with many risk factors including genetic and lifestyle factors.

Methods: PubMed, Web of Science, Embase and Scopus and the Google Scholar search engine in addition to Persian databases including Magiran and SID were searched using relevant keywords. The associations of opium use, long duration of opium use, high daily amount opium use and high cumulative opium use and GI cancer and various subtypes of GI cancers were estimated and pooled in format of odds ratios (OR) and their corresponding 95% confidence intervals (CI) with a random effects model.

Results: 22 articles that were published between 1983 and 2022 entered the analyses. There were significant relationships between opium use based on crude effect sizes (OR: 2.53, 1.95-3.29) and adjusted effect sizes (OR: 2.64, 1.99-3.51), high daily opium use (or: 3.41, 1.92-6.06), long duration of opium use (OR: 3.03, 1.90-4.84) and high cumulative opium use (OR: 3.88, 2.35-6.41), all compared to never opium use, and GI cancer. The results were not sensitive to sensitivity analyses and no influential publication biases were found in these analyses.

Conclusion: Our meta-analysis showed that opium use could be associated with increased risk of overall and some particular GI cancers including oropharyngeal, gastric, pancreatic and colorectal cancers. Opium use as a potentially modifiable factor, therefore, should be more emphasized.

Keywords: Cancer; Gastrointestinal tract; Meta-analysis; Opium.

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Conflict of interest statement

The authors declare no competing financial interests.

Figures

Figure 1
Figure 1
PRISMA 2020 flowchart of study identification, screening and selection process
Figure 2
Figure 2
Forest plots of the individual and pooled (a) crude and (b) adjusted effect sizes of opium use and various GI cancers
Figure 3
Figure 3
Forest plots of the individual and pooled effect sizes for the association of (a) high daily dose of opium use compared to never use and GI cancer (b) long duration of opium use compared to never use and GI cancer (c) high cumulative opium use compared to never use and GI cancer
Figure 4
Figure 4
Funnel plots of observed studies and studies imputed by Trim and fill analysis on association of (a) opium use and GI cancer based on crude effect sizes (b) opium use and GI cancer based on adjusted effect sizes (c) long duration of opium use compared to never use and GI cancer
See this image and copyright information in PMC

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