Abstract
BackgroundAs more states legalize cannabis for medical and recreational use, people increasingly use cannabis to treat medical conditions and associated symptoms. The prevalence and utility of cannabis for cancer-related symptoms may be clarified by examining cannabis use among patients with a common cancer diagnosis. We aimed to determine the prevalence of cannabis use among colorectal cancer (CRC) survivors and its associations with quality of life (QoL) and cancer-related symptomatology.MethodsA cross-sectional survey of patient-reported QoL outcomes and behaviors, including cannabis use, was conducted within the Patient Outcomes To Advance Learning network’s (PORTAL) CRC Cohort. The cohort included a population-based sample of healthcare system members ≥18 years old diagnosed with adenocarcinoma of the colon or rectum from 2010 through 2016. We assessed the association between cannabis use and QoL using the European Organization for Research and Treatment of Cancer QLQ-C30 summary score.ResultsOf the 1784 respondents, 293 (16.4%) reported cannabis use following CRC diagnosis. Current tobacco smokers were more likely to use cannabis compared to former or never tobacco smokers (adjusted odds ratio [aOR] 2.71, 95% confidence interval [CI] 1.56 to 4.70). Greater alcohol use (> 4 drinks per month versus ≤4 drinks per month) was associated with cannabis use (aOR 2.17, 95% CI 1.65 to 2.85). There was an association between cannabis use and cancer stage at diagnosis, with stage 3 or 4 CRC patients more likely to use cannabis than stage 1 or 2 CRC patients (aOR 1.68, 95% CI 1.25 to 2.25). After adjusting for demographics, medical comorbidities, stage and site of CRC diagnosis, and prescription opioid use, people who used cannabis had significantly lower QoL than people who did not use cannabis (difference of − 6.14, 95% CI − 8.07 to − 4.20).ConclusionAmong CRC survivors, cannabis use was relatively common, associated with more advanced stages of disease, associated with tobacco and alcohol use, and not associated with better QoL. Clinicians should inquire about cannabis use among their patients and provide evidence-based recommendations for cancer-related symptoms.
Highlights
As more states legalize cannabis for medical and recreational use, people increasingly use cannabis to treat medical conditions and associated symptoms
Cannabis use was more likely in patients diagnosed with stage 3 or 4 colorectal cancer (CRC) than stage 1 or 2 CRC
After adjusting for demographics, comorbidities, stage and site of cancer diagnosis, and prescription opioid use, the mean summary quality of life (QoL) score was 6.14 points lower in people who used cannabis compared to people who did not use cannabis
Summary
As more states legalize cannabis for medical and recreational use, people increasingly use cannabis to treat medical conditions and associated symptoms. The prevalence and utility of cannabis for cancer-related symptoms may be clarified by examining cannabis use among patients with a common cancer diagnosis. We aimed to determine the prevalence of cannabis use among colorectal cancer (CRC) survivors and its associations with quality of life (QoL) and cancer-related symptomatology. As more states legalize cannabis for medical and recreational use, people increasingly use cannabis to treat medical conditions and associated symptomatology. The role of cannabis to treat pain [5], reduce cancer-related anorexia [6], and improve quality of life among patients living with cancer remains inconclusive [6, 7]. The prevalence and utility of cannabis use for cancer-related symptoms may be clarified by examining cannabis use among patients with a common cancer diagnosis. We hypothesized that cannabis use would not be associated with better patient-reported functional measures nor better QoL measures
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