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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Marijuana Use and the Risk of Lung and Upper Aerodigestive Tract Cancers: Results of a Population-Based Case-Control Study

Mia Hashibe, Hal Morgenstern, Yan Cui, Donald P. Tashkin, Zuo-Feng Zhang, Wendy Cozen, Thomas M. Mack and Sander Greenland
Mia Hashibe
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Hal Morgenstern
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Yan Cui
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Donald P. Tashkin
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Zuo-Feng Zhang
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Wendy Cozen
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Thomas M. Mack
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Sander Greenland
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DOI: 10.1158/1055-9965.EPI-06-0330 Published October 2006
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Abstract

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)

  • Cancer
  • epidemiology
  • marijuana
  • cannabis
  • smoking

Footnotes

  • Grant support: NIH grants DA11386, CA90833, CA77954, CA09142, CA96134, and ES011667; and the Alper Research Program for Environmental Genomics of the UCLA Jonsson Comprehensive Cancer Center.

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted July 27, 2006.
    • Received April 26, 2006.
    • Revision received July 27, 2006.
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Cancer Epidemiology Biomarkers & Prevention: 15 (10)
October 2006
Volume 15, Issue 10
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Marijuana Use and the Risk of Lung and Upper Aerodigestive Tract Cancers: Results of a Population-Based Case-Control Study
Mia Hashibe, Hal Morgenstern, Yan Cui, Donald P. Tashkin, Zuo-Feng Zhang, Wendy Cozen, Thomas M. Mack and Sander Greenland
Cancer Epidemiol Biomarkers Prev October 1 2006 (15) (10) 1829-1834; DOI: 10.1158/1055-9965.EPI-06-0330

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Marijuana Use and the Risk of Lung and Upper Aerodigestive Tract Cancers: Results of a Population-Based Case-Control Study
Mia Hashibe, Hal Morgenstern, Yan Cui, Donald P. Tashkin, Zuo-Feng Zhang, Wendy Cozen, Thomas M. Mack and Sander Greenland
Cancer Epidemiol Biomarkers Prev October 1 2006 (15) (10) 1829-1834; DOI: 10.1158/1055-9965.EPI-06-0330
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