The effect of opium consumption on prostate cancer among Iranian patients: A retrospective analytical study

Prostate cancer is one of the most common and serious cancers among Iranian men. Given the high prevalence of opium use in Iran and its classification as a group 1 carcinogen, understanding its potential association with prostate cancer is of clinical and public health importance. This study aimed to evaluate the relationship between opium consumption and pathological findings of prostate biopsy among men referred to Shahid Bahonar Hospital in Kerman. This retrospective cross-sectional study included 441 men who underwent prostate biopsy between 2014 and 2019 due to elevated prostate-specific antigen (PSA > 4 ng/mL) or abnormal digital rectal examination. Patients with a previous diagnosis of prostate cancer, history of pelvic radiotherapy, or a family history of prostate cancer were excluded. Participants were categorized into opium users (n = 143) and non-users (n = 298) based on self-reported opium consumption. Demographic characteristics, PSA levels, prostate volume, Gleason score, clinical and pathological stage, and risk group were extracted from medical records. Statistical analyses were performed using independent t-test and chi-square test with a significance level of .05. There were no significant differences in age or body mass index between the 2 groups (P > .05). The proportion of biopsy-confirmed prostate cancer was significantly higher in non-users (63.8%) compared with opium users (53.1%; P = .033). Mean PSA level was also significantly higher in non-users (54.22 ± 1.64) than in opium users (52.28 ± 2.64; P = .046). No significant differences were observed between the groups regarding prostate volume, Gleason score, clinical stage, pathological stage, or risk group classification (P > .05). Opium consumption was not associated with more advanced clinical or pathological features of prostate cancer. However, opium users showed lower PSA levels and a lower rate of cancer detection compared with non-users, suggesting that opium may influence PSA levels and potentially affect prostate cancer detection. Further studies are recommended to clarify the biological effects of opium on PSA and diagnostic accuracy.