Cannabis use among cancer survivors in the United States: Analysis of a nationally representative sample

Abstract

Background Research on cannabis use among those with a history of cancer is limited. Methods Prevalence of past‐year cannabis use among individuals with and without a cancer history and predictors of use within these 2 groups were determined using data from the Population Assessment of Tobacco and Health study, a nationally representative, longitudinal survey conducted in the United States (waves 1‐4; 2013‐2018). Discrete time survival analyses were used to estimate baseline (wave 1) predictors (physical health status, mental health status, pain, and demographic variables) on past‐year engagement with cannabis within individuals who reported a cancer diagnosis at wave 1 (n = 1022) and individuals who reported never having cancer at any wave (n = 19,702). Results At the most recent survey, 8% of cancer survivors reported past‐year cannabis use, compared with 15% of those without a cancer history. Across 4 time points, an estimated 3.8% of cancer survivors engaged with cannabis, as compared to 6.5% of those without a cancer history. Across both groups, older age and having health insurance were associated with lower likelihood of engaging in cannabis use, whereas greater levels of pain were associated with higher likelihood of engaging in cannabis use. Among those without a cancer history, being female, White, and having better mental health status were associated with lower likelihood of engaging in cannabis use. Conclusions Although cannabis use prevalence is lower among cancer survivors, the reasons for use are not markedly different from those without a cancer history. Continued monitoring of use, reasons for use, and harms or benefits is warranted. Lay Summary Results from this study, which uses data from the Population Assessment of Tobacco and Health Study, indicate that cannabis use is generally increasing across cancer survivors and those without a history of cancer. Cancer survivors are using cannabis at slightly lower rates than those without a history of cancer. Factors related to pain seem to be more prevalent in cancer populations relative to the general population, and could be contributing to cannabis use within cancer survivor populations.

The siren's song of anonymous web‐based sampling

“…The cited study, in fact, observed a 16% cannabis prevalence, and among the 16% of users, 56%—9% overall—reported using cannabis in the past 30 days 4 . Indeed, with prior studies reporting prevalence estimates ranging from 8% to 24%, the results of the current report are nearly double the upper range of any prior study among general oncology patients 5‐10 or patients diagnosed with cancers at specific anatomic sites 4,11,12 . To our knowledge, only Pergam et al 8 have reported on cannabis use among patients with breast cancer at a single cancer center in Seattle, Washington, where adult medical and nonmedical cannabis use is legal.…”

Medical Marijuana Legalization and Opioid- and Pain-Related Outcomes Among Patients Newly Diagnosed With Cancer Receiving Anticancer Treatment

“…The prevalence of pain among this population was as high as 55% during anticancer treatment . National studies have revealed important age differences in marijuana use among cancer survivors, finding younger survivors more likely to report past or recent marijuana use, greater accessibility, and lower perceived risks associated with marijuana compared with their counterparts without cancer . By focusing on adult patients younger than age 65 years receiving cancer treatment, we sought to shed light on the implications of medical marijuana legalization for a population that has elevated needs for cancer pain management but also is potentially more likely to use medical marijuana.…”

Cannabis use is associated with pain severity and interference among cancer survivors

“…(10) Several cross-sectional surveys have linked cannabis use among cancer survivors to the presence of pain. (11,12) In addition, prior work among cancer survivors, has associated characteristics such as male sex, lack of insurance, younger age and lower education to cannabis use. (3,11) One study found that those with cancer who use cannabis are more likely to have chronic pain that impacts their daily activities (high impact chronic pain).…”