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The Marginal Causal Effect of Opium Consumption on the Upper Gastrointestinal Cancer Death Using Parametric G-Formula: An Analysis of 49,946 Cases in the Golestan Cohort Study, Iran Publisher Pubmed



Mohammadi N1 ; Alimohammadian M2, 3 ; Feizesani A2 ; Poustchi H2 ; Alizadeh A4 ; Yaseri M1 ; Mansournia MA1 ; Sadjadi A2, 5
Authors
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Authors Affiliations
  1. 1. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Human Ecology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
  5. 5. No Way New Way Company, The Hague, Netherlands

Source: PLoS ONE Published:2021


Abstract

Upper gastrointestinal (UGI) cancer, including esophageal and gastric, is one of the most common cancers in the world. Hence, the determination of risk factors of UGI helps to reduce the economic and social burden of this cancer in communities. In Iran, the consumption of opium because of its neighborhood with Afghanistan are considerable. In this study, we examine the causal effect of opium use on the time to UGI cancer death. Based on the Golestan Cohort Study (GCS) in northeastern of Iran, about 50000 adults were enrolled to the study for four years (2004–2008) and followed annually until July 2018. We used “parametric g-formula” to study the causal effect of opium use on the time to death due to UGI. In this study, the information of 49946 individuals due to missingness were analyzed. So the median of follow-up time was 144 months and the prevalence of opium use was 17% (about 8489 persons). During the follow-up period, 593 (1.2%) death from upper gastrointestinal cancer were reported. The study showed that the effect of opium use on the time to UGI death was statistically significant (adjusted risk-ratio based on parametric g-formula = 1.31, 95% CI: [1.04, 1.65]). Additionally, the Population Attributable Fraction (PAF) in UGI cancer deaths of opium use was estimated 5.3% (95% CI: [0.6%, 11.3%]). Our results showed a causal effect of opium use on the intensity of upper gastrointestinal cancer death. © 2021 Mohammadi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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