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Research Article Open Access
Introduction: To evaluate any potential effect of narcotics (opioids) abuse on the natural course and mode of clinical presentation of colorectal cancer.
Method: By evaluating recorded DATA in a referral center during a 9 years period from 2004 to 2013 and dividing and comparing cases of colorectal cancer based on the history of opiate abuse.
Results: Overall 351 cases of colorectal cancer included. 79 cases diagnosed as colon cancer, 254 cases as rectal cancer and 18 patients as colorectal tumors. The median age of male and female patients were 60 and 56.1 year. 54.7% of patients were male (192 people). Most of the patients have been diagnosed between age 51 to 70 (43.58%). After dividing patients based on opiate addiction history, overall 28 patientslocated in group A as opiate abusers(7 with colon cancers(2%), 20 with rectal cancer (4.8%) and 1 with colorectal tumor (0.3%) and the rest of patients located in group B as non-opiate users (323 patients). There was a significant difference in habituates such as smoking (P=0.0001) and sexual distribution while there was no meaningful demographic difference for viewpoint of age and family history. Although the average age of opiate abusers was lower than the control group but this difference was non-meaningful (P=0.105). The rate of distant metastasis and mortality were 7.14% and 25% in group A and 19.19% and 10.31% in group B respectively (P=0.113 and 0.389). Comparison of pattern of clinical presentation between 2 groupsrevealed that not only the mode of presentation differed between two groups but also the relative distribution of clinical symptoms were also different. There was a meaningful difference in prevalence ofmelena as a presenting sign between 2 groups(P=0.046) while other differences were non-significant statistically (P>0.05).
Conclusion: Opium abusing can change the clinical picture of colorectal cancers and result in diagnosing delay. With considering its coactivities such as sigarrete smoking, it is highly recommended to discourage its abuse and warning general population about potential hazards.
Colorectal cancer, Metastatic colorectal cancer, Colorectal surgery