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5 Cancer
Pages 141-160

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From page 141...
... . These potential risk factors for cancer have prompted epidemiological research examining the association between cannabis use and the risk of developing several types of cancer, including lung, head and neck, testicular, esophageal, and other cancers that occur in adults, as well as cancers that occur in children.
From page 142...
... The impact of key characteristics of cannabis smoking (e.g., intensity and duration of cannabis smoking, cumulative exposure, age at start of smoking) on lung cancer incidence was evaluated for all study participants and for a subgroup who were not tobacco smokers.
From page 143...
... (2015) found no statistically significant association between smoking cannabis and lung cancer incidence; this was true for all study participants as well as for the subgroup of study participants who were not tobacco smokers.
From page 144...
... in order to evaluate the association between cannabis use and the incidence of head and neck cancers, including upper aerodigestive tract, oral cavity, and nasopharyngeal cancers as well as on head and neck squamous cell carcinoma. After adjusting for tobacco use, age, gender, and race, the meta-analysis found no significant association between cannabis use and head and neck cancers (OR, 1.021, 95% CI = 0.912–1.143)
From page 145...
... . Compared to participants who never smoked cannabis, participants who reported ever smoking cannabis had a statistically nonsignificant increased risk of developing testicular germ cell tumors (OR, 1.19, 95% CI = 0.72–1.95)
From page 146...
... Additionally, the review included limited information on the methods used to conduct the meta-analysis. CONCLUSION 5-3 There is limited evidence of a statistical association between current, frequent, or chronic cannabis smoking and non-seminoma-type testicular germ cell tumors.
From page 147...
... Investigators collected data on the use of cannabis, tobacco, and alcohol as well as relevant medical, environmental, and socioeconomic information. After adjustments were made for demographic factors and alcohol and tobacco use, study participants with cumulative cannabis exposure equal to 1 to 10 joint-years were found to have a statistically nonsignificant decreased risk of developing esophageal cancer compared to participants who never used cannabis (OR, 0.77, 95% CI = 0.36–1.6)
From page 148...
... . However, when compared to participants who did not smoke cannabis or who had smoked cannabis on only one to six occasions, those who were current or former cannabis smokers were not at statistically significant risk of developing prostate or cervical cancer, after adjusting for tobacco and alcohol use and other potential confounders.
From page 149...
... . The lack of a statistical difference in non-Hodgkin lymphoma risk between cannabis users and nonusers was true whether participants reported using cannabis only 1 to 5 times (OR, 0.68, 95% CI = 0.34–1.38)
From page 150...
... . After stratifying cannabis use by levels of cumulative cannabis exposure, the authors found that the depression in bladder cancer risk was statistically significant only for participants who reported smoking cannabis on 3–10 occasions (HR, 0.57, 95% CI = 0.34–0.96)
From page 151...
... Other investigators have noted that this control group may not be appropriate for assessing the association between cannabis use and anal cancer incidence, as cannabis smoking is a potential risk factors for colorectal cancer (Hashibe et al., 2005)
From page 152...
... Additionally, since important biological distinctions exist among cancers that occur in a given organ, including histological and molecular subtypes, such research will need to separately investigate and identify the risk factors associated with each. CONCLUSION 5-5 There is insufficient evidence to support or refute a statistical association between cannabis use and the incidence of prostate cancer, cervical cancer, malignant gliomas, non-Hodgkin lymphoma, penile cancer, anal cancer, Kaposi's sarcoma, or bladder cancer.
From page 153...
... by 17 years of age and matched to 610 controls by age, race, and residential location, and they found that children whose mothers used cannabis during, or in the 3 months preceding, pregnancy were at significantly lower risk of developing AML than children whose mothers did not use cannabis during that period, after adjusting for household income and parental age and education (OR, 0.43, 95% CI = 0.23–0.80) .3 Among children whose mothers reported using cannabis in the 3 months before pregnancy, those whose mothers used cannabis at least once weekly had a lower risk of developing AML than those whose mothers used cannabis less than once weekly (OR, 0.19, 95% CI = 0.06–0.59 versus OR, 0.57, 95% CI = 0.26–1.29)
From page 154...
... (1990) conducted a case-control study involving 163 cases diagnosed by 14 years of age with astrocytoma or related tumors and matched to controls by age, race, and residential location, and they found a borderline statistically significant association between maternal use of cannabis in the 10 months preceding their child's birth and the risk of astrocytoma (OR, 2.8, 95% CI = 0.9–9.9, p = 0.07)
From page 155...
... In the latter study, very few mothers reported using cannabis more than once per day during any of the measured time periods, suggesting the potential for underreporting the frequency of cannabis use. Additionally, there was insufficient data to assess dose–response relationships; findings on paternal cannabis use were limited due to low response rates; and confidence intervals were wide due to the small number of women reporting cannabis use during and just before pregnancy.
From page 156...
... CONCLUSION 5-6  There is insufficient evidence to support or refute a statistical association between parental cannabis use and a subsequent risk of developing acute myeloid leukemia/ acute non-lymphoblastic leukemia, acute lymphoblastic leu kemia, rhabdomyosarcoma, astrocytoma, or neuroblastoma in offspring. RESEARCH GAPS To address the research gaps relevant to cancer incidence, the committee suggests the following: • There is need for robust epidemiological studies to investigate the association between cannabis exposure and several types of can cers, including but not limited to lung, head and neck, testicular, and esophageal cancers.
From page 157...
... There is limited evidence of a statistical association between cannabis smoking and: Non-seminoma-type testicular germ cell tumors (current, frequent, or •  chronic cannabis smoking)
From page 158...
... Some of these risk factors, such as family cancer history, occupational exposures, and diet, are difficult to measure and were often not accounted for by the studies reviewed in this chapter. Additionally, the long incubation period of many cancers requires a similarly extended observation period, and that makes it difficult to fully characterize the relevant cannabis exposure and to control for other relevant exposures.
From page 159...
... 2015. Cannabis exposure and risk of testicular cancer: A systematic review and meta-analysis.
From page 160...
... 2015. Cannabis smoking and lung cancer risk: Pooled analysis in the International Lung Cancer Consortium.


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