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Opium use and risk of mortality from digestive diseases: A prospective cohort study

Malekzadeh, M.M. and Khademi, H. and Pourshams, A. and Etemadi, A. and Poustchi, H. and Bagheri, M. and Khoshnia, M. and Sohrabpour, A.A. and Aliasgari, A. and Islami, F. and Jafari, E. and Semnani, S. and Abnet, C.C. and Pharoah, P.D. and Brennan, P. and Boffetta, P. and Dawsey, S.M. and Malekzadeh, R. and Kamangar, F. (2013) Opium use and risk of mortality from digestive diseases: A prospective cohort study. American Journal of Gastroenterology, 108 (11). pp. 1757-1765.

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Abstract

Objectives:Opium use, particularly in low doses, is a common practice among adults in northeastern Iran. We aimed to investigate the association between opium use and subsequent mortality from disorders of the digestive tract.Methods:We used data from the Golestan Cohort Study, a prospective cohort study in northeastern Iran, with detailed, validated data on opium use and several other exposures. A total of 50,045 adults were enrolled during a 4-year period (2004-2008) and followed annually until December 2012, with a follow-up success rate of 99. We used Cox proportional hazard regression models to evaluate the association between opium use and outcomes of interest.Results:In all, 8,487 (17) participants reported opium use, with a mean duration of 12.7 years. During the follow-up period 474 deaths from digestive diseases were reported (387 due to gastrointestinal cancers and 87 due to nonmalignant etiologies). Opium use was associated with an increased risk of death from any digestive disease (adjusted hazard ratio (HR)=1.55, 95 confidence interval (CI)=1.24-1.93). The association was dose dependent, with a HR of 2.21 (1.57-3.31) for the highest quintile of cumulative opium use vs. no use (P trend =0.037). The HRs (95 CI) for the associations between opium use and malignant and nonmalignant causes of digestive mortality were 1.38 (1.07-1.76) and 2.60 (1.57-4.31), respectively. Increased risks were seen both for smoking opium and for ingestion of opium.Conclusions:Long-term opium use, even in low doses, is associated with increased risk of death from both malignant and nonmalignant digestive diseases.

Item Type: Article
Additional Information: cited By 8
Uncontrolled Keywords: adult; aged; alcohol consumption; article; cause of death; cohort analysis; digestive system cancer; disease association; esophagus cancer; female; follow up; gastrointestinal disease; human; Iran; liver disease; major clinical study; male; mortality; opiate addiction; priority journal; prospective study; risk factor; smoking; stomach cancer, Adult; Aged; Cohort Studies; Digestive System Diseases; Drug Users; Female; Humans; Incidence; Iran; Male; Middle Aged; Opium; Prospective Studies; Risk; Survival Rate
Subjects: کهورت
مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
موارد کلی
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 20 Apr 2015 08:37
Last Modified: 19 May 2015 04:08
URI: http://eprints.goums.ac.ir/id/eprint/2568

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