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Independent Risk Factors of Bladder Cancer: Perspective From an Iranian Province

By: Gavin Calabretta, BS
Posted: Monday, January 10, 2022

A matched case-control study published in the Asian Pacific Journal of Cancer Prevention found an association among opium consumption, cigarette smoking, and low income and an increased bladder cancer risk. According to Armita Shahesmaelli, MD, PhD, of Kerman University of Medical Sciences, Iran, and colleagues, bladder cancer is the most common cancer among men in the Kerman province of Iran, despite being the ninth most common cancer in the world.

“The observed strong dose-response association between opium consumption, cigarette smoking, and bladder cancer highlights the need for extension of harm-reduction programs, especially in regions with [a] high burden of disease,” the study authors remarked.

The study enrolled 100 patients with bladder cancer and 200 healthy individuals matched in age and sex. Via a structured questionnaire, information on sociodemographic status, occupational exposures, common diet, history of drug use, and family history of cancer was collected. Bivariate and multivariate analyses were conducted on these data to determine potential bladder cancer risk factors.

It appeared that compared with people who never used opium, those who used up to 18,000 g/year had an increased risk of bladder cancer (adjusted odds ratio [AOR] = 6, 95% confidence interval [CI] = 2.3–15.5). This risk was elevated further in individuals consuming more than 18,000 g/year (AOR = 11.3, 95% CI = 2.3–15.5). Additionally, when compared with individuals who had never smoked, those who smoked up to 20 pack-years had an increased disease risk (AOR = 3.4, 95% CI = 1.3–8.9). Following a similar trend, those smoking more than 20 pack-years had an even higher risk of developing bladder cancer (AOR = 15.8, 95% CI = 5.9–42.4). It also appeared that those earning more than 20 million rials in yearly income (approximately $475 US) had a decreased cancer risk (AOR = 0.41, 95% CI = 0.18–0.092).

Disclosure: The study authors reported no conflicts of interest.



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