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The risk of cancer among persons with a history of injecting drug use in Sweden - a cohort study based on participants in a needle exchange program.

Reepalu, Anton; Alanko, Marianne LU ; Björk, Jonas LU ; Widell, Anders LU and Björkman, Per LU (2012) In Acta oncologica (Stockholm, Sweden) 51(1). p.51-56
Abstract
Abstract Background. Injecting drug use (IDU) may lead to exposure to a range of carcinogenic agents. We investigated the risk and distribution of cancers among individuals with a history of IDU in Sweden. Material and Methods. The cancer incidence in a cohort of longitudinally followed participants in a needle exchange program (NEP), recruited between 1987 and 2007, was compared to that in the Swedish general population, matching for age group and gender. Baseline demographic and drug use data were collected and longitudinal testing of serological markers for HIV, hepatitis B and C virus was performed during NEP participation. Standardized incidence ratios (SIR) for types of cancer found in the study cohort were calculated, using data... (More)
Abstract Background. Injecting drug use (IDU) may lead to exposure to a range of carcinogenic agents. We investigated the risk and distribution of cancers among individuals with a history of IDU in Sweden. Material and Methods. The cancer incidence in a cohort of longitudinally followed participants in a needle exchange program (NEP), recruited between 1987 and 2007, was compared to that in the Swedish general population, matching for age group and gender. Baseline demographic and drug use data were collected and longitudinal testing of serological markers for HIV, hepatitis B and C virus was performed during NEP participation. Standardized incidence ratios (SIR) for types of cancer found in the study cohort were calculated, using data from the Swedish National Cancer Registry for reference. Results. The mean follow-up time for the 3255 participants was 11.8 years, constituting 38 419 person years at risk. The mean age at end of follow-up was 42.7 years, and 75% of participants were men. Seventy-eight cases of cancer were observed (SIR 1.1 [95% CI = 0.9-1.4]). The SIR was significantly increased for five cancer types among men; primary liver, laryngeal, lung, oropharyngeal and non-melanoma skin cancer (respective SIR 12.8 [95% CI = 4.2-30.0], 9.2 [95% CI = 1.9-26.8], 3.2 [95% CI = 1.5-6.1], 7.3 [95% CI = 1.5-21.2], and 3.5 [95% CI = 1.1-8.2]), and for cancers of endocrine organs among women (5.3 [95% CI = 1.7-12.4]). Conclusion. Although the standardized overall cancer incidence in this relatively young IDU cohort was similar to that in the general population, the risk of specific types of cancer was significantly increased, suggesting that IDU confers elevated risks for certain malignancies. These findings prompt further studies to investigate causative factors and suggest the need for surveillance among persons with a history of IDU. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Acta oncologica (Stockholm, Sweden)
volume
51
issue
1
pages
51 - 56
publisher
Taylor & Francis
external identifiers
  • wos:000298002000007
  • pmid:22150166
  • scopus:83455246691
ISSN
1651-226X
DOI
10.3109/0284186X.2011.626445
language
English
LU publication?
yes
id
59507a85-d9d4-4a37-a2f6-042e12d35877 (old id 2274339)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22150166?dopt=Abstract
date added to LUP
2012-01-03 16:28:54
date last changed
2017-06-04 04:13:05
@article{59507a85-d9d4-4a37-a2f6-042e12d35877,
  abstract     = {Abstract Background. Injecting drug use (IDU) may lead to exposure to a range of carcinogenic agents. We investigated the risk and distribution of cancers among individuals with a history of IDU in Sweden. Material and Methods. The cancer incidence in a cohort of longitudinally followed participants in a needle exchange program (NEP), recruited between 1987 and 2007, was compared to that in the Swedish general population, matching for age group and gender. Baseline demographic and drug use data were collected and longitudinal testing of serological markers for HIV, hepatitis B and C virus was performed during NEP participation. Standardized incidence ratios (SIR) for types of cancer found in the study cohort were calculated, using data from the Swedish National Cancer Registry for reference. Results. The mean follow-up time for the 3255 participants was 11.8 years, constituting 38 419 person years at risk. The mean age at end of follow-up was 42.7 years, and 75% of participants were men. Seventy-eight cases of cancer were observed (SIR 1.1 [95% CI = 0.9-1.4]). The SIR was significantly increased for five cancer types among men; primary liver, laryngeal, lung, oropharyngeal and non-melanoma skin cancer (respective SIR 12.8 [95% CI = 4.2-30.0], 9.2 [95% CI = 1.9-26.8], 3.2 [95% CI = 1.5-6.1], 7.3 [95% CI = 1.5-21.2], and 3.5 [95% CI = 1.1-8.2]), and for cancers of endocrine organs among women (5.3 [95% CI = 1.7-12.4]). Conclusion. Although the standardized overall cancer incidence in this relatively young IDU cohort was similar to that in the general population, the risk of specific types of cancer was significantly increased, suggesting that IDU confers elevated risks for certain malignancies. These findings prompt further studies to investigate causative factors and suggest the need for surveillance among persons with a history of IDU.},
  author       = {Reepalu, Anton and Alanko, Marianne and Björk, Jonas and Widell, Anders and Björkman, Per},
  issn         = {1651-226X},
  language     = {eng},
  number       = {1},
  pages        = {51--56},
  publisher    = {Taylor & Francis},
  series       = {Acta oncologica (Stockholm, Sweden)},
  title        = {The risk of cancer among persons with a history of injecting drug use in Sweden - a cohort study based on participants in a needle exchange program.},
  url          = {http://dx.doi.org/10.3109/0284186X.2011.626445},
  volume       = {51},
  year         = {2012},
}