Marijuana Use and the Risk of Lung and Upper Aerodigestive Tract Cancers: Results of a Population-Based Case-Control Study

• Published in: Cancer epidemiology, biomarkers & prevention Vol. 15; no. 10; pp. 1829 - 1834
• Main Authors: Hashibe, Mia, Morgenstern, Hal, Cui, Yan, Tashkin, Donald P., Zhang, Zuo-Feng, Cozen, Wendy, Mack, Thomas M., Greenland, Sander
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Association for Cancer Research 01.10.2006
• Subjects: Adenocarcinoma - epidemiology; Adenocarcinoma - etiology; Adolescent; Adult; Aged; Alcohol Drinking - adverse effects; Biological and medical sciences; Cancer; cannabis; Carcinoma, Large Cell - epidemiology; Carcinoma, Large Cell - etiology; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - etiology; Case-Control Studies; Confounding Factors (Epidemiology); Digestive System Neoplasms - epidemiology; Digestive System Neoplasms - etiology; epidemiology; Esophageal Neoplasms - epidemiology; Esophageal Neoplasms - etiology; Female; Humans; Incidence; Laryngeal Neoplasms - epidemiology; Laryngeal Neoplasms - etiology; Los Angeles - epidemiology; Male; marijuana; Marijuana Smoking - adverse effects; Marijuana Smoking - epidemiology; Medical sciences; Middle Aged; Mouth Neoplasms - epidemiology; Mouth Neoplasms - etiology; Pharyngeal Neoplasms - epidemiology; Pharyngeal Neoplasms - etiology; Pneumology; Population Surveillance; Respiratory Tract Neoplasms - epidemiology; Respiratory Tract Neoplasms - etiology; Risk Factors; smoking; Time Factors; Tumors; Tumors of the respiratory system and mediastinum; California; United States; North America; America; Los Angeles; Human; Lung disease; Respiratory disease; Lung cancer; Cannabidaceae; Malignant tumor; Case control study; Epidemiology; Cannabis; Cancerology; Dicotyledones; Angiospermae; Risk factor; Bronchus disease; ENT disease; Marijuana; Head and neck cancer; Spermatophyta; Drug of abuse; Hashish; Public health
• ISSN: 1055-9965; 1538-7755
• DOI: 10.1158/1055-9965.EPI-06-0330

Background: Despite several lines of evidence suggesting the biological plausibility of marijuana being carcinogenic, epidemiologic findings are inconsistent. We conducted a population-based case-control study of the association between marijuana use and the risk of lung and upper aerodigestive tract cancers in Los Angeles. Methods: Our study included 1,212 incident cancer cases and 1,040 cancer-free controls matched to cases on age, gender, and neighborhood. Subjects were interviewed with a standardized questionnaire. The cumulative use of marijuana was expressed in joint-years, where 1 joint-year is equivalent to smoking one joint per day for 1 year. Results: Although using marijuana for ≥30 joint-years was positively associated in the crude analyses with each cancer type (except pharyngeal cancer), no positive associations were observed when adjusting for several confounders including cigarette smoking. The adjusted odds ratio estimate (and 95% confidence limits) for ≥60 versus 0 joint-years was 1.1 (0.56, 2.1) for oral cancer, 0.84 (0.28, 2.5) for laryngeal cancer, and 0.62 (0.32, 1.2) for lung cancer; the adjusted odds ratio estimate for ≥30 versus 0 joint-years was 0.57 (0.20, 1.6) for pharyngeal cancer, and 0.53 (0.22, 1.3) for esophageal cancer. No association was consistently monotonic across exposure categories, and restriction to subjects who never smoked cigarettes yielded similar findings. Conclusions: Our results may have been affected by selection bias or error in measuring lifetime exposure and confounder histories; but they suggest that the association of these cancers with marijuana, even long-term or heavy use, is not strong and may be below practically detectable limits. (Cancer Epidemiol Biomarkers Prev 2006;15(10):1829–34)