Olivia Welch , Natalia Hefteh , Mahdi Sheikh , Adam La Caze , Marie-Odile Parat
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Abstract
Background
The International Agency for Cancer Research monographs recently classified opium consumption as carcinogenic to humans, with sufficient evidence for carcinogenicity in the larynx, lung, and urinary bladder and limited evidence in the oesophagus, pancreas, stomach, and pharynx. This causes concerns of a potential cancer-promoting effect in the same organs associated with the use of pharmaceutical opioids.
Methods
We performed a systematic review (registered in the Open Science Framework: osf.io/xyg9p) of the published in vivo preclinical literature to determine whether the effects of opioids on tumour growth and metastasis are organ specific. We investigated whether the opioid category (agonist, antagonist, or peptide), organ of origin of the cancer cells, site of tumour measurement, immune status of rodents, opioid dose, or duration of opioid exposure was associated with reported cancer outcomes.
Results
A total of 118 studies, representing 168 experiments, were included. Most animal experiments (94/168, 56%) reported an anti-cancer effect of opioids and 31 (18%) reported a pro-cancer effect. Of the assessed parameters, opioid category (P<0.001) and opioid dose (P=0.0056) were the only factors significantly associated with the reported cancer outcome. In studies testing morphine, experiments showing a cancer-promoting effect predominantly administered low doses of morphine (the proportion of studies using low-dose morphine was 65% among those reporting pro-cancer outcomes vs 8% among those reporting anti-cancer outcomes).
Conclusions
We found no relationship indicative of an organ-specific, cancer-promoting effect of opioids.
期刊介绍：
The British Journal of Anaesthesia (BJA) is a prestigious publication that covers a wide range of topics in anaesthesia, critical care medicine, pain medicine, and perioperative medicine. It aims to disseminate high-impact original research, spanning fundamental, translational, and clinical sciences, as well as clinical practice, technology, education, and training. Additionally, the journal features review articles, notable case reports, correspondence, and special articles that appeal to a broader audience.
The BJA is proudly associated with The Royal College of Anaesthetists, The College of Anaesthesiologists of Ireland, and The Hong Kong College of Anaesthesiologists. This partnership provides members of these esteemed institutions with access to not only the BJA but also its sister publication, BJA Education. It is essential to note that both journals maintain their editorial independence.
Overall, the BJA offers a diverse and comprehensive platform for anaesthetists, critical care physicians, pain specialists, and perioperative medicine practitioners to contribute and stay updated with the latest advancements in their respective fields.
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