학술논문
Unveiling an Association between Waterpipe Smoking and Bladder Cancer Risk: A Multicenter Case-Control Study in Iran.
Document Type
Academic Journal
Author
Hadji M; Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland.; Rashidian H; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.; Marzban M; Department of Public Health, School of Public Health, Bushehr University of Medical Science, Bushehr, Iran.; Clinical Research Development Center, The Persian Gulf Martyrs, Bushehr University of Medical Science, Bushehr, Iran.; Rezaianzadeh A; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.; Ansari-Moghaddam A; Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.; Bakhshi M; Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.; Nejatizadeh A; Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.; Seyyedsalehi MS; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.; Naghibzadeh-Tahami A; Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.; Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran.; Haghdoost A; 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.; Mohebbi E; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.; Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia.; Freedman ND; Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.; Malekzadeh R; Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.; Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.; Etemadi A; Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.; Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.; Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.; Kamangar F; Department of Biology, School of Computer, Mathematical and Natural Sciences, Morgan State University, Baltimore, Maryland.; Weiderpass E; International Agency for Research on Cancer, Lyon, France.; Pukkala E; Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland.; Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.; Boffetta P; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.; Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York.; Zendehdel K; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.; Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
Source
Publisher: American Association for Cancer Research Country of Publication: United States NLM ID: 9200608 Publication Model: Print Cited Medium: Internet ISSN: 1538-7755 (Electronic) Linking ISSN: 10559965 NLM ISO Abbreviation: Cancer Epidemiol Biomarkers Prev Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Limited data exist for the association between bladder cancers and waterpipe smoking, an emerging global public health concern.
Methods: We used the IROPICAN database in Iran and used multivariable logistic regression, adjusting for cigarette smoking, opium use, and other confounding factors. In addition, we studied the association between exclusive waterpipe smoking and bladder cancer.
Results: We analyzed 717 cases and 3,477 controls and a subset of 215 patients and 2,145 controls who did not use opium or cigarettes. Although the OR adjusted for opium, cigarettes, and other tobacco products was 0.92 [95% confidence interval (CI), 0.69-1.20], we observed a statistically significant elevated risk in exclusive waterpipe smokers (OR = 1.78; 95% CI, 1.16-2.72) compared with non-users of opium or any tobacco. Associations were strongest for smoking more than two heads/day (OR = 2.25; 95% CI, 1.21-4.18) and for initiating waterpipe smoking at an age less than 20 (OR = 2.73; 95% CI, 1.11-6.72). The OR for urothelial bladder cancer was higher in ex-smokers (OR = 2.35; 95% CI, 1.24-4.42) than in current smokers (OR = 1.52; 95% CI, 0.72-3.15). All observed associations were consistently higher for urothelial histology.
Conclusions: Waterpipe smoking may be associated with an increased risk of bladder cancer, notably among individuals who are not exposed to cigarette smoking and opium.
Impact: The study provides compelling evidence that waterpipe smoking is a confirmed human carcinogen, demanding action from policymakers. See related In the Spotlight, p. 461.
(©2024 The Authors; Published by the American Association for Cancer Research.)
Methods: We used the IROPICAN database in Iran and used multivariable logistic regression, adjusting for cigarette smoking, opium use, and other confounding factors. In addition, we studied the association between exclusive waterpipe smoking and bladder cancer.
Results: We analyzed 717 cases and 3,477 controls and a subset of 215 patients and 2,145 controls who did not use opium or cigarettes. Although the OR adjusted for opium, cigarettes, and other tobacco products was 0.92 [95% confidence interval (CI), 0.69-1.20], we observed a statistically significant elevated risk in exclusive waterpipe smokers (OR = 1.78; 95% CI, 1.16-2.72) compared with non-users of opium or any tobacco. Associations were strongest for smoking more than two heads/day (OR = 2.25; 95% CI, 1.21-4.18) and for initiating waterpipe smoking at an age less than 20 (OR = 2.73; 95% CI, 1.11-6.72). The OR for urothelial bladder cancer was higher in ex-smokers (OR = 2.35; 95% CI, 1.24-4.42) than in current smokers (OR = 1.52; 95% CI, 0.72-3.15). All observed associations were consistently higher for urothelial histology.
Conclusions: Waterpipe smoking may be associated with an increased risk of bladder cancer, notably among individuals who are not exposed to cigarette smoking and opium.
Impact: The study provides compelling evidence that waterpipe smoking is a confirmed human carcinogen, demanding action from policymakers. See related In the Spotlight, p. 461.
(©2024 The Authors; Published by the American Association for Cancer Research.)