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Hadji M, Rashidian H, Marzban M, Gholipour M, Naghibzadeh-Tahami A, Mohebbi E, Ebrahimi E, Hosseini B, Haghdoost AA, Rezaianzadeh A, Rahimi-Movaghar A, Moradi A, Seyyedsalehi MS, Shirkoohi R, Poustchi H, Eghtesad S, Najafi F, Safari-Faramani R, Alizadeh-Navaei R, Ansari Moghadam AR, Bakhshi M, Nejatizadeh A, Mahmudi M, Shahid-Sales S, Ahmadi-Simab S, Nabavian O, Boffetta P, Pukkala E, Weiderpass E, Kamangar F, Zendehdel K. The Iranian Study of Opium and Cancer (IROPICAN): Rationale, Design, and Initial Findings. Arch Iran Med 2021; 24:167-176. [PMID: 33878874 DOI: 10.34172/aim.2021.27] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/11/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The International Agency for Research on Cancer (IARC) recently classified opium use as a Group 1 carcinogen. However, much remains to be studied on the relation between opium and cancer. We designed the Iranian Opium and Cancer (IROPICAN) study to further investigate the association of opium use and cancers of the head and neck, bladder, lung, and colon and rectum. In this paper, we describe the rationale, design, and some initial results of the IROPICAN Study. METHODS The IROPICAN is a multi-center case-control study conducted in 10 provinces of Iran. The cases were all histologically confirmed and the controls were selected from hospital visitors who were free of cancer, were not family members or friends of the cancer patients, and were visiting the hospital for reasons other than their own ailment. The questionnaires included detailed questions on opium use (including age at initiation, duration, frequency, typical amount, and route), and potential confounders, such as tobacco use (e.g., cigarettes, nass and water-pipe), and dietary factors. Biological samples, including blood and saliva, were also collected. RESULTS The validation and pilot phases showed reasonably good validity, with sensitivities of 70% and 69% for the cases and controls, respectively, in reporting opium use. The results also showed excellent reliability, with intra-class correlation coefficients of 0.96 for ever opium use and 0.88 (95% CI: 0.80, 0.92) for regular opium use. In the main phase, we recruited 3299 cancer cases (99% response rate) and 3477 hospital visitor controls (89% response rate). The proportion of ever-use of opium was 40% among cases and 18% among controls. CONCLUSION The IROPICAN study will serve as a major resource in studies addressing the effect of opium on risk of cancers of the head and neck, bladder, lung, and colon and rectum.
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Affiliation(s)
- Maryam Hadji
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamideh Rashidian
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Marzban
- Clinical Research Development Center, "The Persian Gulf Martyrs", Bushehr University of Medical Science, Bushehr, Iran
- Department of Public Health, School of Public Health, Bushehr University of Medical Science, Bushehr, Iran
| | - Mahin Gholipour
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ahmad Naghibzadeh-Tahami
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Elham Mohebbi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
- Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman
| | - Elmira Ebrahimi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Bayan Hosseini
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
- International Agency for Research on Cancer, Lyon, France
| | - Ali Akbar Haghdoost
- Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran
- Regional Knowledge HUB for HIV/AIDS Surveillance, Research Centre for Modelling in Health, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolvahab Moradi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Reza Shirkoohi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sareh Eghtesad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, Institute of Health, Kermanshah Medical Sciences University, Kermanshah, Iran
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roya Safari-Faramani
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah Medical Sciences University, Kermanshah, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Mahdieh Bakhshi
- Health Promotion Research Center, Zahedan University of Medical sciences, Zahedan, Iran
| | - Azim Nejatizadeh
- Bandar-e-Abbas University of Medical Sciences, Bandar-e-Abbas, Iran
| | - Masumeh Mahmudi
- Bandar-e-Abbas University of Medical Sciences, Bandar-e-Abbas, Iran
| | | | | | - Omid Nabavian
- Department of Anesthesiology, Imam Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA
- Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Eero Pukkala
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Finnish Cancer Registry - Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | | | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
- Breast Disease Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
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