2720 - Characterization of Cannabis Use In Patients with Prostate, Lung, and Breast Cancer Enrolled in a Statewide Multicenter Cohort
Presenter(s)
M. M. Cousins1,2, L. Higgins1, M. P. Dykstra1, H. Yin1,3, K. Griffith3,4, M. Schipper1,4, M. M. Dominello5, R. Sharma6, J. Johnson-Olokesusi1,3, V. Bavireddy1,3, M. Mietzel1,3, D. Kendrick1,3, R. T. Dess1,3, D. K. Heimburger7, S. Jolly1,3, F. A. Vicini8, L. J. Pierce1,3, E. Covington1,3, and M. L. Mierzwa1,3; 1Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, 2Department of Radiation Oncology, Self Regional Healthcare, Greenwood, SC, 3Michigan Radiation Oncology Quality Consortium Coordinating Center, Ann Arbor, MI, 4Department of Biostatistics, University of Michigan, Ann Arbor, MI, 5Department of Radiation Oncology, Karmanos Cancer Center, Detroit, MI, 6Department of Radiation Oncology, West Michigan Cancer Center, Kalamazoo, MI, 7Munson Healthcare, Traverse City, MI, 8Michigan Health Professionals, Farmington Hills, MI
Purpose/Objective(s): Patients with cancer frequently use cannabis, and there is a paucity of consensus guidance on cannabis use in this population. The goal of this work is to provide insight into cannabis use patterns in patients with prostate, lung, and breast cancer undergoing definitive therapy.
Materials/Methods: Patients enrolled into Michigan Radiation Oncology Quality Consortium (MROQC) prostate cancer, lung cancer, and breast cancer cohorts from 2021-2025 were asked to answer questions about cannabis use, mode of administration, and active ingredient. Analysis included summary statistics, chi square testing, and univariate logistic regression.
Results: Of 18,411 eligible patients (Prostate 4115, Lung 3275, Breast 11,021), 12,702/18,411 (69%) completed study questionnaires (Prostate 3464, Lung 1579, Breast 7659), and 11,081/12,702 (87.2%) answered cannabis use questions (Prostate 2912, Lung 1259, Breast 6910). Recent (last 30 days) cannabis use rates were 14.4%, 18.7%, and 14.0% for patients with prostate (418/2912), lung (236/1259), and breast (966/6910) cancer, respectively. About half of patients who recently used cannabis did so frequently (>/= 10 days per month; Prostate: 55.0% 230/418, Lung: 53.8% 127/236, Breast: 48.0% 464/966), with about one quarter reporting daily use (Prostate: 22.7%, Lung: 27.5%, Breast: 22.7%). Rankings of most common modes of administration (seen in >10% of patients, categories not mutually exclusive) differed for prostate (eating or drinking: 44.0%; smoking: 57.2%; multiple: 21.3%), lung (smoking: 42%; eating or drinking: 37.3%; multiple: 20.8%), and breast (eating or drinking: 33.0%; smoking: 26.2%; multiple: 18.0%; topical 10.8%) patients. Patients favored tetrahydrocannabinol (THC)-dominant products (Prostate: 50.5%; Lung: 34.8%; Breast: 21.1%) to cannabidiol (CBD)-dominant products (Prostate: 7.9%; Lung: 3.8%; Breast: 12.3%). Many patients did not know the main active ingredient in the product chosen (Prostate: 17.7%; Lung: 14.8%; Breast: 13.0%). In the prostate, lung, and breast cohorts, younger age, not married or partnered, tobacco smoking, and lower levels of education predicted recent cannabis use (P<0.001). In lung, but not prostate and breast, there was evidence of increasing adoption of cannabis with each passing year of the study with significant increase in percentage of patients endorsing recent cannabis use from 15.8% in 2021 to 23.0% in 2025 (P=0.0373).
Conclusion: Patients seeking definitive management of cancer are often using cannabis. Among those using cannabis, many are using THC-dominant cannabis products through varied administration means. Rates of cannabis use among patients with lung cancer appear to be increasing. Provider/patient education and development of reliable datasets to assess risks and benefits of cannabis use are critical across disease sites.