OA Epidemiology

Lifestyle Risk Factors of Gastric Cancer and Its Precancerous Lesions in a Long-Term Cohort Study: Neglected Role of Opium and Hookah

Proceedings of the 2013 annual meeting of the Netherlands Epidemiology Society

Volume 1 Issue S1 Abstract 46

 

A. Sadjadi, Tehran University, Iran; University of Groningen, the Netherlands
M. H. Derakhshan, Tehran University, Iran; University of Glasgow, UK
M. Boreiri, Tehran University of Medical Sciences, Iran
M. Parsaeian, Tehran University of Medical Sciences, Tehran, Iran
M. Alimohammadian, Tehran University of Medical  Sciences, Tehran, Iran
M. Babaei, Ardabil University of Medical Sciences, Iran
F. Samadi, Ardabil University of Medical Sciences, Iran
A. Etemadi, Tehran University, Iran; National Cancer Institute, Bethesda, USA
E.  Ahmadi, Tehran University of Medical Sciences, Iran
A. Delavari, Tehran University of Medical Sciences, Iran
M. Sotoudeh, Tehran University of Medical Sciences, Iran
F. Farzadfar, Tehran University of Medical Sciences, Tehran, Iran
A. Nikmanesh, Tehran University of Medical Sciences, Iran
F. Islami, Tehran University; Mount Sinai School of Medicine, New York, USA
B.Z. Alizadeh, Tehran University, Iran; University of Groningen, the Netherlands

Background
A recent study showed an association between opium/hookah use and gastric cancer. We aim to investigate the relationship between opium/hookah and gastric precancerous lesions and subsequent gastric cancer.

Methods
In a population-based cohort study, 928 randomly selected, healthy, Helicobacter pylori- infected subjects in Ardabil Province, Iran, were followed for 10 years. We calculated odds ratios  (ORs) and 95% confidence intervals (CIs) for the association between lifestyle factors and baseline precancerous lesions and hazard ratios (HR) and 95% CIs for the associations of baseline lifestyle risk factors and endoscopic and histological parameters with incident gastric cancers. Additionally, we calculated the proportion of cancers attributable to specific modifiable risk factors.

Results
During 9,096 person-years of follow-up, 36 new cases of gastric cancer yielded an incidence rate of 3.96/1000 persons-year. Opium use was strongly associated with baseline antral and body intestinal metaplasia. Opium (HR:3.2;95%CI:1.4-7.7), hookah (HR:3.4; 95%CI:1.7-7.1) and cigarette (HR:3.2;95%CI:1.4-7.5) use, as well as high salt intake, family history of gastric cancer, gastric ulcer, and histological atrophic gastritis and intestinal metaplasia of gastric body were associated with higher risk of gastric cancer. The fraction of cancers attributable jointly to high salt, low fruit intake, smoking and opium  was 93% (95%CI:83%-98%) in this H.pylori positive population.

Conclusion
Opium and hookah use are risk factors for gastric cancer. The association between opium/hookah and gastric cancer extends to precancerous lesions. Opium, hookah, cigarette smoking and high salt intake are important modifiable lifestyle risk factors in a high incidence area of gastric cancer.

Published: 06 Jun, 2013

 
Licensee OA Publishing London 2013. Creative Commons Attribution License (CC-BY)