title: Opium use, cigarette smoking, and alcohol consumption in relation to pancreatic cancer.
abstract: OBJECTIVE
  Although several studies have suggested opium as a risk factor for cancers of the esophagus, stomach, larynx, lung, and bladder, no previous study has examined the association of opium with pancreatic cancer. We aimed to study the association between opium use and risk of pancreatic cancer in Iran, using a case-control design. We also studied the association of cigarette smoking and alcohol consumption with pancreatic cancer, for which little information was available from this population.
  
  
  METHODS
  Cases and controls were selected from patients who were referred to 4 endoscopic ultrasound centers in Tehran, Iran. We recruited 316 histopathologically (all adenocarcinoma) and 41 clinically diagnosed incident cases of pancreatic cancer, as well as 328 controls from those with a normal pancreas in enodosonography from January 2011 to January 2015. We used logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  After adjustment for potential confounders, opium use (OR 1.91; 95% CI 1.06-3.43) and alcohol consumption (OR 4.16; 95% CI 1.86-9.31) were significantly associated with an increased risk of pancreatic cancer. We did not find an association between ever tobacco smoking and pancreatic cancer risk (OR 0.93; 95% CI 0.62-1.39).
  
  
  CONCLUSIONS
  In our study, opium use and alcohol consumption were associated with an increased risk of pancreatic cancer, whereas cigarette smoking was not.
authors.affiliation: Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences Gastrointestinal and Liver Disease Research Center, Firoozgar Hospital, Iran University of Medical Sciences Sasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Clinic, Tehran, Iran Division of Gastroenterology and Hepatology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins Medical Institutions, Baltimore, MD American Cancer Society, Atlanta, GA Institute for Transitional Epidemiology and the Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY.
authors.forename: Ramin
authors.initials: R
authors.lastname: Shakeri
authors.forename: Farin
authors.initials: F
authors.lastname: Kamangar
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mohamadnejad
authors.forename: Reza
authors.initials: R
authors.lastname: Tabrizi
authors.forename: Farhad
authors.initials: F
authors.lastname: Zamani
authors.forename: Ashraf
authors.initials: A
authors.lastname: Mohamadkhani
authors.forename: Sepideh
authors.initials: S
authors.lastname: Nikfam
authors.forename: Arash
authors.initials: A
authors.lastname: Nikmanesh
authors.forename: Masoud
authors.initials: M
authors.lastname: Sotoudeh
authors.forename: Rasoul
authors.initials: R
authors.lastname: Sotoudehmanesh
authors.forename: Bijan
authors.initials: B
authors.lastname: Shahbazkhani
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Ostovaneh
authors.forename: Farhad
authors.initials: F
authors.lastname: Islami
authors.forename: Hossein
authors.initials: H
authors.lastname: Poustchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
authors.forename: Akram
authors.initials: A
authors.lastname: Pourshams
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D016022:Case-Control Studies; D019160:Endosonography; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009892:Opium / Q000009:adverse effects*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires
chemical_list: D009892:Opium