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Principal Investigator
Mahdi Sheikh
M.D., Ph.D.
Internatioanl Agency for Research on Cancer (IARC - WHO)
Position Title
About this CDAS Project
PLCO (Learn more about this study)
Project ID
Initial CDAS Request Approval
May 11, 2021
Opioid Cohort Consortium (OPICO) to investigate the effects of opioid use on cancer incidence and mortality
The recent opioid crisis has caused thousands of deaths annually and billions of dollars in economic losses worldwide. Opioids include opiates (minimally processed natural opioids including opium and heroin) and pharmaceutical opioids (semi-synthetic or synthetic opioids, including fentanyl, morphine, oxycodone). In October 2020, opium consumption was classified as “carcinogenic to humans” by the IARC Monographs, based on evidence for cancers of the larynx (2.5-fold increase in risk for ever use of opium), lung (2.2-fold), and bladder (2.9-fold).
Pharmaceutical opioids are either synthesized from opium or act on some shared receptors and pathways as opium. Multiple lines of evidence have begun to raise concerns about the long-term health consequences of using pharmaceutical opioids. These include experimental studies showing tumor-initiating and promoting effects and associations in registry linkage studies for lung, liver, pancreas, and urogenital cancers. However, it has been impossible to rigorously evaluate whether pharmaceutical opioids are associated with cancer incidence or mortality due to the paucity of data on opioid use and insufficient statistical power in prospective cohort studies.
To overcome these limitations, we initiated the Opioid Cohort Consortium (OPICO) in 2020 with pilot funding from the NIH and Wellcome Trust, through the Global Genomic Medicine Collaborative (G2MC). The OPICO aims to gather and harmonize data on the use of opiates and prescription opioids from large prospective cohorts around the world.

1. Organize data on opioid use from large-scale prospective cohorts around the world
2. Assess the type, distribution, and extent of opioid use across diverse populations;
3. Determine the association of opioid use with cancer incidence;
4. Determine the association of opioid use with all-cause and cause-specific mortality.


1. Dr. Hilary Robbins (International Agency for Research on Cancer, France)
2. Dr. Paul Brenna (International Agency for Research on Cancer, France)
3. Dr. Pietro Ferrari (International Agency for Research on Cancer, France)
4. Dr. Neal Freedman (National Cancer Institute, USA)
5. Professor Farin Kamangar (Morgan State University, USA)
6. Dr. Lesley Tinker (Fred Hutchinson Cancer Research Center, USA)
7. Professor Mara Vitolins (Wake Forest University, USA)
8. Dr. Chris Gillet (Wake Forest University, USA)
9. Professor Louisa Degenhardt (University of New South Wales, Australia)
10. Professor Sallie-Anne Pearson (University of New South Wales, Australia)
11. Professor Emily Banks (Australian National University, Australia)
12. Professor Karen Canfell (University of Sydney, Australia)
13. Dr. Marianne Weber (University of Sydney, Australia)
14. Dr. Peter Sarich (University of Sydney, Australia)
15. Professor Reza Malekzadeh (Tehran University of Medical Sciences, Iran)
16. Dr. Hossein Poustchi (Tehran University of Medical Sciences, Iran)
17. Professor Marcel Goldberg (Paris Descartes University, France)