Morgan A Marks1, Anil K Chaturvedi, Karl Kelsey, Kurt Straif, Julien Berthiller, Stephen M Schwartz, Elaine Smith, Annah Wyss, Paul Brennan, Andrew F Olshan, Qingyi Wei, Erich M Sturgis, Zuo-Feng Zhang, Hal Morgenstern, Joshua Muscat, Philip Lazarus, Michael McClean, Chu Chen, Thomas L Vaughan, Victor Wunsch-Filho, Maria Paula Curado, Sergio Koifman, Elena Matos, Ana Menezes, Alexander W Daudt, Leticia Fernandez, Marshall Posner, Paolo Boffetta, Yuan-Chin Amy Lee, Mia Hashibe, Gypsyamber D'Souza. 1. Authors' Affiliations: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville; Johns Hopkins School of Medicine; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Community Health, School of Medicine, Brown University, Providence, Rhode Island; International Agency of Research on Cancer; Hospices Civils de Lyon, Pole Information Medicale Evaluation Recherche; Universite Lyon 1, Equipe d'Accueil 4129; International Prevention Research Institute, Lyon, France; Fred Hutchinson Cancer Research Cancer, Seattle, Washington; University of Iowa College of Public Health, Iowa City, Iowa; School of Public Health, University of North Carolina, Chapel Hill, North Carolina; Department of Head and Neck Surgery and Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas; UCLA School of Public Health, Los Angeles, California; Departments of Epidemiology and Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan; Penn State College of Medicine, Hershey, Pennsylvania; Boston University School of Public Health, Boston, Massachusetts; Faculdade de Saude Publica, Universidade de Sao Paulo, Sao Paulo; Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz, Rio de Janeiro; Universidade Federal de Pelotas, Pelotas; Hospital de Clinicas de Porto Alegre, Port Alegre, Brazil; Institute Oncology Angel H. Roffo, University of Buenos Aires, Buenos Aires, Argentina; Institute of Oncology and Radiobiology, Havana, Cuba; The Tisch Cancer Institute Mount Sinai School of Medicine, New York, New York; and University of Utah School of Medicine, Salt Lake City, Utah.
Abstract
BACKGROUND: The incidence of oropharyngeal and oral tongue cancers has increased over the last 20 years which parallels increased use of marijuana among individuals born after 1950. METHODS: A pooled analysis was conducted comprising individual-level data from nine case-control studies from the United States and Latin America in the INHANCE consortium. Self-reported information on marijuana smoking, demographic, and behavioral factors was obtained from 1,921 oropharyngeal cases, 356 oral tongue cases, and 7,639 controls. RESULTS: Compared with never marijuana smokers, ever marijuana smokers had an elevated risk of oropharyngeal [adjusted OR (aOR), 1.24; 95% confidence interval (CI): 1.06-1.47] and a reduced risk of oral tongue cancer (aOR, 0.47; 95% CI, 0.29, 0.75). The risk of oropharyngeal cancer remained elevated among never tobacco and alcohol users. The risk of oral tongue cancer was reduced among never users of tobacco and alcohol. Sensitivity analysis adjusting for potential confounding by HPV exposure attenuated the association of marijuana use with oropharyngeal cancer (aOR, 0.99; 95% CI, 0.71-1.25), but had no effect on the oral tongue cancer association. CONCLUSIONS: These results suggest that the association of marijuana use with head and neck carcinoma may differ by tumor site. IMPACT: The associations of marijuana use with oropharyngeal and oral tongue cancer are consistent with both possible pro- and anticarcinogenic effects of cannabinoids. Additional work is needed to rule out various sources of bias, including residual confounding by HPV infection and misclassification of marijuana exposure.
BACKGROUND: The incidence of oropharyngeal and oral tongue cancers has increased over the last 20 years which parallels increased use of marijuana among individuals born after 1950. METHODS: A pooled analysis was conducted comprising individual-level data from nine case-control studies from the United States and Latin America in the INHANCE consortium. Self-reported information on marijuana smoking, demographic, and behavioral factors was obtained from 1,921 oropharyngeal cases, 356 oral tongue cases, and 7,639 controls. RESULTS: Compared with never marijuana smokers, ever marijuana smokers had an elevated risk of oropharyngeal [adjusted OR (aOR), 1.24; 95% confidence interval (CI): 1.06-1.47] and a reduced risk of oral tongue cancer (aOR, 0.47; 95% CI, 0.29, 0.75). The risk of oropharyngeal cancer remained elevated among never tobacco and alcohol users. The risk of oral tongue cancer was reduced among never users of tobacco and alcohol. Sensitivity analysis adjusting for potential confounding by HPV exposure attenuated the association of marijuana use with oropharyngeal cancer (aOR, 0.99; 95% CI, 0.71-1.25), but had no effect on the oral tongue cancer association. CONCLUSIONS: These results suggest that the association of marijuana use with head and neck carcinoma may differ by tumor site. IMPACT: The associations of marijuana use with oropharyngeal and oral tongue cancer are consistent with both possible pro- and anticarcinogenic effects of cannabinoids. Additional work is needed to rule out various sources of bias, including residual confounding by HPV infection and misclassification of marijuana exposure.
Authors: Yu-Hui Jenny Huang; Zuo-Feng Zhang; Donald P Tashkin; Bingjian Feng; Kurt Straif; Mia Hashibe Journal: Cancer Epidemiol Biomarkers Prev Date: 2015-01 Impact factor: 4.254
Authors: Robbie Woods; Esther M O'Regan; Susan Kennedy; Cara Martin; John J O'Leary; Conrad Timon Journal: World J Clin Cases Date: 2014-06-16 Impact factor: 1.337
Authors: Virginia E Drake; Carole Fakhry; Melina J Windon; C Matthew Stewart; Lee Akst; Alexander Hillel; Wade Chien; Patrick Ha; Brett Miles; Christine G Gourin; Rajarsi Mandal; Wojciech K Mydlarz; Lisa Rooper; Tanya Troy; Siddhartha Yavvari; Tim Waterboer; Nicole Brenner; David W Eisele; Gypsyamber D'Souza Journal: Cancer Date: 2021-01-11 Impact factor: 6.860
Authors: Francesca Bravi; Yuan-Chin Amy Lee; Mia Hashibe; Paolo Boffetta; David I Conway; Monica Ferraroni; Carlo La Vecchia; Valeria Edefonti Journal: Oral Dis Date: 2020-07-16 Impact factor: 3.511