{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T19:38:47Z","timestamp":1793648327682,"version":"4.5.1"},"reference-count":81,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T00:00:00Z","timestamp":1612742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004748","name":"Mashhad University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004748","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["thelancet.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["EClinicalMedicine"],"published-print":{"date-parts":[[2021,3]]},"DOI":"10.1016\/j.eclinm.2021.100768","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T18:26:26Z","timestamp":1614191186000},"page":"100768","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":26,"special_numbering":"C","title":["Opium as a carcinogen: A systematic review and meta-analysis"],"prefix":"10.1016","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1112-794X","authenticated-orcid":false,"given":"Mohammad Zamiri","family":"Bidary","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1075-8731","authenticated-orcid":false,"given":"Mehrdad","family":"Sahranavard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash Akhavan","family":"Rezayat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Omranzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyyed Hasan","family":"Hoseiny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Kabirian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8656-1444","authenticated-orcid":false,"given":"Amirhossein","family":"Sahebkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.eclinm.2021.100768_bib0001","unstructured":"Organization WH. Cancer. 2018. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/cancer (accessed 6\/3\/2020 2020)."},{"issue":"4","key":"10.1016\/j.eclinm.2021.100768_bib0002","first-page":"994","article-title":"Incidence, mortality, and epidemiological aspects of cancers in Iran; differences with the world data","volume":"21","author":"Almasi","year":"2016","journal-title":"J BUON: Off J Balkan Union Oncol"},{"key":"10.1016\/j.eclinm.2021.100768_bib0003","series-title":"Epidemiologic and Histopathologic Feature of Lung Cancer in Central Iran (2012-2018)","author":"Khalilian","year":"2020"},{"key":"10.1016\/j.eclinm.2021.100768_bib0004","doi-asserted-by":"crossref","DOI":"10.1093\/jnci\/djz241","article-title":"Genetic factors, adherence to healthy lifestyle behavior, and risk of invasive breast cancer among women in the UK Biobank","author":"Arthur","year":"2020","journal-title":"J Natl Cancer Inst"},{"issue":"6","key":"10.1016\/j.eclinm.2021.100768_bib0005","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1093\/nutrit\/nux012","article-title":"Possible role of diet in cancer: systematic review and multiple meta-analyses of dietary patterns, lifestyle factors, and cancer risk","volume":"75","author":"Grosso","year":"2017","journal-title":"Nutr. Rev."},{"issue":"8","key":"10.1016\/j.eclinm.2021.100768_bib0006","doi-asserted-by":"crossref","DOI":"10.1289\/EHP1249","article-title":"Ambient air pollution and cancer mortality in the cancer prevention study II","volume":"125","author":"Turner","year":"2017","journal-title":"Environ. Health Perspect."},{"issue":"1","key":"10.1016\/j.eclinm.2021.100768_bib0007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-018-20616-6","article-title":"Occupational exposure to polycyclic aromatic hydrocarbons and elevated cancer incidence in firefighters","volume":"8","author":"Stec","year":"2018","journal-title":"Sci Rep"},{"issue":"28","key":"10.1016\/j.eclinm.2021.100768_bib0008","article-title":"Opium use, cigarette smoking, and alcohol consumption in relation to pancreatic cancer","volume":"95","author":"Shakeri","year":"2016","journal-title":"Medicine (Baltimore)Medicine (Baltimore)"},{"issue":"5","key":"10.1016\/j.eclinm.2021.100768_bib0009","doi-asserted-by":"crossref","first-page":"e505","DOI":"10.1097\/SCS.0000000000001089","article-title":"Opium usage as an etiologic factor of oral cavity cancer","volume":"25","author":"Razmpa","year":"2014","journal-title":"J Craniofac Surg"},{"issue":"90","key":"10.1016\/j.eclinm.2021.100768_bib0010","first-page":"19","article-title":"Opium addiction and risk of laryngeal and esophageal carcinoma","volume":"29","author":"Bakhshaee","year":"2017","journal-title":"Iran J Otorhinolaryngol"},{"issue":"8088","key":"10.1016\/j.eclinm.2021.100768_bib0011","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/S0140-6736(78)92218-3","article-title":"Ingested mutagens from opium and tobacco pyrolysis products and cancer of the oesophagus","volume":"312","author":"Hewer","year":"1978","journal-title":"Lancet North Am Ed"},{"issue":"1","key":"10.1016\/j.eclinm.2021.100768_bib0012","first-page":"19","article-title":"Opium addiction and risk of laryngeal and esophageal carcinoma","volume":"29","author":"Bakhshaee","year":"2017","journal-title":"Iran J Otorhinolaryngol"},{"key":"10.1016\/j.eclinm.2021.100768_bib0013","series-title":"Bladder cancer risk factors among isfahan population: a case-control study","author":"Toutounchi","year":"2000"},{"issue":"12","key":"10.1016\/j.eclinm.2021.100768_bib0014","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1038\/nrcardio.2013.159","article-title":"Effects of opium consumption on cardiometabolic diseases","volume":"10","author":"Masoudkabir","year":"2013","journal-title":"Nat Rev Cardiol"},{"issue":"5","key":"10.1016\/j.eclinm.2021.100768_bib0015","first-page":"553","article-title":"Presence of lead in opium","volume":"11","author":"Aghaee-Afshar","year":"2008","journal-title":"Arch Iran Med"},{"issue":"4","key":"10.1016\/j.eclinm.2021.100768_bib0016","article-title":"Epidemiologic study of opium use in pars cohort study: a study of 9000 adults in a rural Southern Area of Iran","volume":"20","author":"Fallahzadeh","year":"2017","journal-title":"Arch Iran Med (AIM)"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0017","first-page":"188","article-title":"Opium and its alkaloids","volume":"66","author":"Schiff","year":"2002","journal-title":"Am J Pharm Educ"},{"key":"10.1016\/j.eclinm.2021.100768_bib0018","series-title":"Crime. world drug report 2019","year":"2019"},{"issue":"6","key":"10.1016\/j.eclinm.2021.100768_bib0019","doi-asserted-by":"crossref","DOI":"10.5812\/ijcm.8227","article-title":"Opium use and risk of lower gastrointestinal cancers: population-based case-control study in South of Iran","volume":"10","author":"Lankarani","year":"2017","journal-title":"Int J Cancer Manage"},{"key":"10.1016\/j.eclinm.2021.100768_bib0020","doi-asserted-by":"crossref","first-page":"436","DOI":"10.3389\/fphys.2016.00436","article-title":"The impact of opium consumption on blood glucose, serum lipids and blood pressure, and related mechanisms","volume":"7","author":"Najafipour","year":"2016","journal-title":"Front Physiol"},{"issue":"4","key":"10.1016\/j.eclinm.2021.100768_bib0021","doi-asserted-by":"crossref","first-page":"587","DOI":"10.4103\/0019-509X.204755","article-title":"Opium consumption: a potential risk factor for lung cancer and pulmonary tuberculosis","volume":"53","author":"Safari","year":"2016","journal-title":"Indian J Cancer"},{"issue":"3","key":"10.1016\/j.eclinm.2021.100768_bib0022","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/YCO.0b013e328338630d","article-title":"Substance abuse among Iranian high school students","volume":"23","author":"Momtazi","year":"2010","journal-title":"Curr Opin Psychiatry"},{"issue":"3","key":"10.1016\/j.eclinm.2021.100768_bib0023","first-page":"254","article-title":"Can opium abuse be a risk factor for carotid stenosis in patients who are candidates for coronary artery bypass grafting?","volume":"17","author":"Shirani","year":"2010","journal-title":"Cardiol J"},{"issue":"11","key":"10.1016\/j.eclinm.2021.100768_bib0024","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.1097\/00005537-200311000-00016","article-title":"Opium and risk of laryngeal cancer","volume":"113","author":"Mousavi","year":"2003","journal-title":"Laryngoscope"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0025","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1002\/ijc.28018","article-title":"Opium: an emerging risk factor for gastric adenocarcinoma","volume":"133","author":"Shakeri","year":"2013","journal-title":"Int J Cancer"},{"key":"10.1016\/j.eclinm.2021.100768_bib0026","first-page":"83","article-title":"Neglected role of hookah and opium in gastric carcinogenesis: a cohort study on risk factors and attributable fractions","volume":"28","author":"Sadjadi","year":"2013","journal-title":"J. Gastroenterol. Hepatol."},{"issue":"1","key":"10.1016\/j.eclinm.2021.100768_bib0027","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1080\/14659891.2018.1523962","article-title":"Tobacco consumption, opium use, alcohol drinking and the risk of esophageal cancer in North Khorasan, Iran","volume":"24","author":"Pournaghi","year":"2019","journal-title":"J Subst Use"},{"issue":"3","key":"10.1016\/j.eclinm.2021.100768_bib0028","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1080\/01635581.2013.779384","article-title":"Cooking methods and esophageal squamous cell carcinoma in high-risk areas of Iran","volume":"66","author":"Hakami","year":"2014","journal-title":"Nutr Cancer"},{"issue":"7","key":"10.1016\/j.eclinm.2021.100768_bib0029","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0022152","article-title":"Prognostic factors for esophageal squamous cell Carcinoma-A Population-Based study in Golestan province, Iran, a high incidence area","volume":"6","author":"Aghcheli","year":"2011","journal-title":"PLoS ONE"},{"issue":"4","key":"10.1016\/j.eclinm.2021.100768_bib0030","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1093\/ije\/dyp195","article-title":"Socio-economic status and oesophageal cancer: results from a population-based case-control study in a high-risk area","volume":"38","author":"Islami","year":"2009","journal-title":"Int J Epidemiol"},{"issue":"4","key":"10.1016\/j.eclinm.2021.100768_bib0031","doi-asserted-by":"crossref","first-page":"A300","DOI":"10.1016\/S0016-5085(08)61400-6","article-title":"Opium, tobacco and alcohol use in relation to esophageal cancer in a high-risk area of Iran","volume":"134","author":"Nasrollahzadeh","year":"2008","journal-title":"Gastroenterology"},{"issue":"10","key":"10.1016\/j.eclinm.2021.100768_bib0032","first-page":"1322","article-title":"Can opium use contribute to a higher risk of colorectal cancers? a matched case-control study in Iran","volume":"45","author":"Naghibzadeh-Taham","year":"2016","journal-title":"Iran. J. Public Health"},{"issue":"8","key":"10.1016\/j.eclinm.2021.100768_bib0033","first-page":"4101","article-title":"Colorectal Cancer Mortality in Shiraz, Iran","volume":"17","author":"Dianatinasab","year":"2016","journal-title":"Asian Pac J Cancer Prev"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0034","doi-asserted-by":"crossref","first-page":"69","DOI":"10.15171\/jnp.2018.17","article-title":"Opium and grade of urothelial bladder cancer","volume":"7","author":"Zeighami","year":"2018","journal-title":"J Nephropathol"},{"issue":"3","key":"10.1016\/j.eclinm.2021.100768_bib0035","doi-asserted-by":"crossref","first-page":"111","DOI":"10.4103\/2278-330X.173174","article-title":"Occupation, smoking, opium, and bladder cancer: a case-control study","volume":"4","author":"Ghadimi","year":"2015","journal-title":"South Asian J Cancer"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0036","first-page":"82","article-title":"Age distribution types of bladder cancers and their relationship with opium consumption and smoking","volume":"6","author":"Aliramaji","year":"2015","journal-title":"Caspian J Intern Med"},{"issue":"9","key":"10.1016\/j.eclinm.2021.100768_bib0037","first-page":"567","article-title":"Opium as a risk factor for bladder cancer: a population-based case-control study in Iran","volume":"18","author":"Akbari","year":"2015","journal-title":"Arch Iran Med"},{"issue":"3","key":"10.1016\/j.eclinm.2021.100768_bib0038","first-page":"601","article-title":"Prominent bladder cancer risk factors in Iran","volume":"11","author":"Shakhssalim","year":"2010","journal-title":"Asian Pac J Cancer Prev"},{"issue":"6","key":"10.1016\/j.eclinm.2021.100768_bib0039","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.urolonc.2008.10.016","article-title":"Opium consumption and risk of bladder cancer: a case-control analysis","volume":"28","author":"Hosseini","year":"2010","journal-title":"Urol Oncol: Semin Orig Investi"},{"issue":"4","key":"10.1016\/j.eclinm.2021.100768_bib0040","first-page":"263","article-title":"Opium use in transitional cell carcinoma of the urinary bladder","volume":"44","author":"Nourbakhsh","year":"2006","journal-title":"Acta Med Iran"},{"issue":"6","key":"10.1016\/j.eclinm.2021.100768_bib0041","first-page":"355","article-title":"Evaluation of bladder cancer in opium addicted patients in the Kerman province, Iran from 1999 to 2003","volume":"10","author":"Ketabchi","year":"2005","journal-title":"J Res Med Sci"},{"issue":"4","key":"10.1016\/j.eclinm.2021.100768_bib0042","first-page":"253","article-title":"Is bladder cancer more common among opium addicts?","volume":"1","author":"Aliasgari","year":"2004","journal-title":"Urol J"},{"issue":"6","key":"10.1016\/j.eclinm.2021.100768_bib0043","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1002\/1097-0142(197906)43:6<2315::AID-CNCR2820430622>3.0.CO;2-J","article-title":"Opium: a potential urinary bladder carcinogen in man","volume":"43","author":"Sadeghi","year":"1979","journal-title":"CancerCancer"},{"issue":"3","key":"10.1016\/j.eclinm.2021.100768_bib0044","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1158\/1055-9965.EPI-17-0592","article-title":"Opium use and risk of pancreatic cancer: a prospective cohort study","volume":"27","author":"Moossavi","year":"2018","journal-title":"Cancer Epidemiol Biomark Prevent"},{"issue":"28","key":"10.1016\/j.eclinm.2021.100768_bib0045","article-title":"Opium use, cigarette smoking, and alcohol consumption in relation to pancreatic cancer","volume":"95","author":"Shakeri","year":"2016","journal-title":"Medicine (United States)"},{"issue":"3","key":"10.1016\/j.eclinm.2021.100768_bib0046","first-page":"167","article-title":"The association between dietary carbohydrate intake and pancreatic cancer risk: a large prospective study","volume":"21","author":"Ghorbani","year":"2016","journal-title":"Govaresh"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0047","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1159\/000338559","article-title":"Opium could be considered an independent risk factor for lung cancer: a case-control study","volume":"85","author":"Masjedi","year":"2013","journal-title":"Respiration"},{"issue":"6","key":"10.1016\/j.eclinm.2021.100768_bib0048","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1002\/ijc.2910200606","article-title":"Risk factors for lung cancer in singapore chinese, a population with high female incidence rates","volume":"20","author":"MacLennan","year":"1977","journal-title":"Int J Cancer"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0049","doi-asserted-by":"crossref","first-page":"e69","DOI":"10.1016\/S1470-2045(13)70550-3","article-title":"Opium use: an emerging risk factor for cancer?","volume":"15","author":"Kamangar","year":"2014","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.eclinm.2021.100768_bib0050","doi-asserted-by":"crossref","first-page":"b2535","DOI":"10.1136\/bmj.b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"339","author":"Moher","year":"2009","journal-title":"BMJ"},{"key":"10.1016\/j.eclinm.2021.100768_bib0051","unstructured":"Wells G., Shea B., O'Connell D., et\u00a0al. The Newcastle-Ottawa Scale (Nos) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp (accessed July 1, 2020 2020)."},{"key":"10.1016\/j.eclinm.2021.100768_bib0052","series-title":"International Classification of Diseases for Oncology: World Health Organization","year":"2013"},{"key":"10.1016\/j.eclinm.2021.100768_bib0053","series-title":"Agents classified by the iarc monographs, volumes 1\u2013127 - IARC Monographs on the Identification of Carcinogenic Hazards to Humans","year":"2020"},{"key":"10.1016\/j.eclinm.2021.100768_bib0054","unstructured":"Institute NC. SEER Training Modules, Site-Specific Modules. https:\/\/training.seer.cancer.gov\/ (accessed November 19 2020,)."},{"issue":"5","key":"10.1016\/j.eclinm.2021.100768_bib0055","doi-asserted-by":"crossref","first-page":"e649","DOI":"10.1016\/S2214-109X(20)30059-0","article-title":"Opium use and subsequent incidence of cancer: results from the Golestan Cohort Study","volume":"8","author":"Sheikh","year":"2020","journal-title":"The Lancet Glob Health"},{"issue":"4","key":"10.1016\/j.eclinm.2021.100768_bib0056","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1007\/s11126-020-09840-4","article-title":"Evaluating the prevalence of PTSD among children and adolescents after earthquakes and floods: a systematic review and meta-analysis","volume":"91","author":"Rezayat","year":"2020","journal-title":"Psychiatr Q"},{"key":"10.1016\/j.eclinm.2021.100768_bib0057","article-title":"The relationship between the opium drug and the risk of laryngeal squamous cell cancer","volume":"5","author":"Berjis","year":"2018","journal-title":"Ambient Scie"},{"issue":"4","key":"10.1016\/j.eclinm.2021.100768_bib0058","doi-asserted-by":"crossref","first-page":"697","DOI":"10.3906\/sag-1907-100","article-title":"Doost Mohammadi F. opium and risk of gastrointestinal cancer: a case-control study","volume":"50","author":"Vazirinejad","year":"2020","journal-title":"Turk J Med Sci"},{"issue":"1","key":"10.1016\/j.eclinm.2021.100768_bib0059","first-page":"2","article-title":"Opium as a risk factor for upper gastrointestinal cancers: a population-based case-control study in Iran","volume":"17","author":"Naghibzadeh tahami","year":"2014","journal-title":"Arch Iran Med"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0060","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1093\/carcin\/18.2.365","article-title":"Opium and oesophageal cancer: effect of morphine and opium on the metabolism of N-nitrosodimethylamine and N-nitrosodiethylamine in the rat","volume":"18","author":"Ribeiro Pinto","year":"1997","journal-title":"CarcinogenesisCarcinogenesis"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0061","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1093\/carcin\/4.2.227","article-title":"Induction of SCE by opium pyrolysates in CHO cells and human peripheral blood lymphocytes","volume":"4","author":"Perry","year":"1983","journal-title":"CarcinogenesisCarcinogenesis"},{"key":"10.1016\/j.eclinm.2021.100768_bib0062","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.urolonc.2008.10.016","article-title":"Opium consumption and risk of bladder cancer: a case-control analysis","volume":"2010","author":"Hosseini","year":"2010","journal-title":"Urol Oncol: Semin Original Investig;"},{"issue":"1\u20132","key":"10.1016\/j.eclinm.2021.100768_bib0063","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/0027-5107(85)90114-9","article-title":"Characterization and identification of 6 mutagens in opium pyrolysates implicated in oesophagel cancer in Iran","volume":"150","author":"Friesen","year":"1985","journal-title":"Mutat Res\/Fundam Mol Mech Mutagen"},{"issue":"3","key":"10.1016\/j.eclinm.2021.100768_bib0064","doi-asserted-by":"crossref","first-page":"e91577","DOI":"10.1371\/journal.pone.0091577","article-title":"The Mu opioid receptor promotes opioid and growth factor-induced proliferation, migration and Epithelial Mesenchymal Transition (EMT) in human lung cancer","volume":"9","author":"Lennon","year":"2014","journal-title":"PLoS ONE"},{"issue":"11","key":"10.1016\/j.eclinm.2021.100768_bib0065","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1038\/ajg.2013.336","article-title":"Opium use and risk of mortality from digestive diseases\u2013a prospective cohort study","volume":"108","author":"Malekzadeh","year":"2013","journal-title":"Am. J. Gastroenterol."},{"issue":"5","key":"10.1016\/j.eclinm.2021.100768_bib0066","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1093\/carcin\/3.5.577","article-title":"Mutagens produced by the pyrolysis of opium and its alkaloids as possible risk factors in cancer of the bladder and oesophagus","volume":"3","author":"Malaveille","year":"1982","journal-title":"CarcinogenesisCarcinogenesis"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0067","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1002\/(SICI)1097-0215(20000415)86:2<289::AID-IJC21>3.0.CO;2-M","article-title":"Cigarette smoking and bladder cancer in men: a pooled analysis of 11 case-control studies","volume":"86","author":"Brennan","year":"2000","journal-title":"Int J Cancer"},{"key":"10.1016\/j.eclinm.2021.100768_bib0068","doi-asserted-by":"crossref","first-page":"e2502","DOI":"10.1136\/bmj.e2502","article-title":"Opium use and mortality in Golestan Cohort Study: prospective cohort study of 50 000 adults in Iran","volume":"344","author":"Khademi","year":"2012","journal-title":"BMJ"},{"issue":"18","key":"10.1016\/j.eclinm.2021.100768_bib0069","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1093\/jnci\/85.18.1483","article-title":"Nutrition intervention trials in Linxian, China: supplementation with specific vitamin\/mineral combinations, cancer incidence, and disease-specific mortality in the general population","volume":"85","author":"Blot","year":"1993","journal-title":"J Natl Cancer Inst"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0070","doi-asserted-by":"crossref","first-page":"791","DOI":"10.7314\/APJCP.2013.14.2.791","article-title":"Colorectal cancer trends in Kerman province, the largest province in Iran, with forecasting until 2016","volume":"14","author":"Roya","year":"2013","journal-title":"Asian Pac J Cancer Prev"},{"issue":"1","key":"10.1016\/j.eclinm.2021.100768_bib0071","first-page":"123","article-title":"Colorectal cancer in Iran: an epidemiological study","volume":"9","author":"Azadeh","year":"2008","journal-title":"Asian Pac J Cancer Prev"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0072","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1136\/tc.2004.009977","article-title":"Pack year\u201d smoking histories: what about patients who use loose tobacco?","volume":"14","author":"Wood","year":"2005","journal-title":"Tob Control"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0073","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1002\/ijc.28018","article-title":"Opium: an emerging risk factor for gastric adenocarcinoma","volume":"133","author":"Shakeri","year":"2013","journal-title":"Int J Cancer"},{"issue":"11","key":"10.1016\/j.eclinm.2021.100768_bib0074","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1016\/S1470-2045(20)30611-2","article-title":"Carcinogenicity of opium consumption","volume":"21","author":"Warnakulasuriya","year":"2020","journal-title":"Lancet Oncol"},{"issue":"1","key":"10.1016\/j.eclinm.2021.100768_bib0075","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/j.1600-0528.1983.tb01354.x","article-title":"Epidemiologic study of oral cancer in Fars Province, Iran","volume":"11","author":"Fahmy","year":"1983","journal-title":"Community Dent Oral Epidemiol"},{"issue":"11","key":"10.1016\/j.eclinm.2021.100768_bib0076","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.1097\/00005537-200311000-00016","article-title":"Opium and risk of laryngeal cancer","volume":"113","author":"Mousavi","year":"2003","journal-title":"Laryngoscope"},{"issue":"5","key":"10.1016\/j.eclinm.2021.100768_bib0077","first-page":"59","article-title":"Demographic characteristics, clinical symptoms and endoscopic findings in patients with gastric ulcer versus","volume":"15","author":"Shokri-Shirvani","year":"2013","journal-title":"Gastr Cancer%J J Babol Univ Med Sci"},{"issue":"2","key":"10.1016\/j.eclinm.2021.100768_bib0078","first-page":"98","article-title":"The effect of smoking and opium on bladder cancer in Yazd Province: a case - control study","volume":"5","author":"Lotfi","year":"2016","journal-title":"SSU"},{"issue":"3","key":"10.1016\/j.eclinm.2021.100768_bib0079","doi-asserted-by":"crossref","first-page":"783","DOI":"10.31557\/APJCP.2020.21.3.783","article-title":"Opium use and head and neck cancers: a matched case-control study in Iran","volume":"21","author":"Alizadeh","year":"2020","journal-title":"J Asian Pacific J Cancer Prevent"},{"issue":"1","key":"10.1016\/j.eclinm.2021.100768_bib0080","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1186\/s12885-020-07296-0","article-title":"Is opium use associated with an increased risk of lung cancer? a case-control study","volume":"20","author":"Naghibzadeh-Tahami","year":"2020","journal-title":"BMC Cancer"},{"key":"10.1016\/j.eclinm.2021.100768_bib0081","article-title":"Opium use and the risk of head and neck squamous cell carcinoma","author":"Mohebbi","year":"2020","journal-title":"Int J Cancer"}],"container-title":["EClinicalMedicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589537021000481?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589537021000481?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T19:03:30Z","timestamp":1762887810000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2589537021000481"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":81,"alternative-id":["S2589537021000481"],"URL":"https:\/\/doi.org\/10.1016\/j.eclinm.2021.100768","relation":{},"ISSN":["2589-5370"],"issn-type":[{"value":"2589-5370","type":"print"}],"subject":[],"published":{"date-parts":[[2021,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Opium as a carcinogen: A systematic review and meta-analysis","name":"articletitle","label":"Article Title"},{"value":"EClinicalMedicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.eclinm.2021.100768","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"100768"}}