Cannabis Smoking and Risk of Lung Cancer - A Systematic Review and Meta-Analysis

khalid BOUTI, Rajae BORKI, Hicham FENANE, Laila HARRAK

Abstract


Background: Cannabis is the illicit psychoactive substance the most consumed in the world. Little is known about the association between the use of cannabis and the risk of lung cancer.

Objective:The objective of this meta-analysis is to determine whether use of cannabis is a risk factor for lung cancer.

Methods: We conducted a systematic review and meta-analyses of all languages articles using relevant computerised databases. MEDLINE (online PubMed), Web of knowledge, Embase, EBSCO CINAHL, ScienceDirect, Scopus, Cochrane Library, and Directory of Open Access Journals were searched to September 2014 for cohorts and case-control studies that assessed the risk of lung cancer associated with cannabis smoking.  The literature search was performed with a combination of medical subject headings terms, "cannabis" and "lung neoplasms". Data extraction: Two investigators independently analysed and extracted results from eligible studies.
Our study's registration number on PROSPERO is  CRD42014008872.

Results: The search strategy identified 2476 citations. 13 studies were eligible for inclusion: 2 pooled analysis of 9 case-control studies, one case-control study and 3 cohorts.
The cumulative analysis for all the studies under a fixed-effects model showed that cannabis smoking determined an increased risk of developing lung cancer in the future (relative risk 1.22, 95% confidence interval 0.999–1.5; p=0.051), with no evidence of heterogeneity across the studies (I2: 34%; p¼0.01).

Conclusions: The use of cannabis with or without tobacco smoking is associated with an increased risk for lung cancer.


Keywords


Cannabis Smoking Risk Of Lung Cancer Systematic Review Meta-Analysis

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References


Hall W, Degenhardt L. Adverse health effects of non-medical cannabis use. Lancet. 2009;374(9698):1383-91.

Maertens RM, White PA, Rickert W, Levasseur G, Douglas GR, Bellier PV, et al. The genotoxicity of mainstream and sidestream marijuana and tobacco smoke condensates. Chemical research in toxicology. 2009;22(8):1406-14.

Callaghan RC, Allebeck P, Sidorchuk A. Marijuana use and risk of lung cancer: a 40-year cohort study. Cancer causes & control : CCC. 2013;24(10):1811-20.

Moir D, Rickert WS, Levasseur G, Larose Y, Maertens R, White P, et al. A comparison of mainstream and sidestream marijuana and tobacco cigarette smoke produced under two machine smoking conditions. Chemical research in toxicology. 2008;21(2):494-502.

Marselos M, Karamanakos P. Mutagenicity, developmental toxicity and carcinogenicity of cannabis. Addiction biology. 1999;4(1):5-12.

Mehra R, Moore BA, Crothers K, Tetrault J, Fiellin DA. The association between marijuana smoking and lung cancer: a systematic review. Archives of internal medicine. 2006;166(13):1359-67.

Aldington S, Harwood M, Cox B, Weatherall M, Beckert L, Hansell A, et al. Cannabis use and risk of lung cancer: a case–control study. European Respiratory Journal. 2008;31(2):280-6.

Rickert WS, Robinson JC, Rogers B. A comparison of tar, carbon monoxide and pH levels in smoke from marihuana and tobacco cigarettes. Canadian journal of public health = Revue canadienne de sante publique. 1982;73(6):386-91.

Alberg AJ, Ford JG, Samet JM. Epidemiology of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132(3 Suppl):29s-55s.

Underner M, Urban T, Perriot J, de Chazeron I, Meurice JC. [Cannabis smoking and lung cancer]. Revue des maladies respiratoires. 2014;31(6):488-98.

Doll R, Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. British medical journal. 1976;2(6051):1525-36.

Doll R, Peto R. Cigarette smoking and bronchial carcinoma: dose and time relationships among regular smokers and lifelong non-smokers. Journal of epidemiology and community health. 1978;32(4):303-13.

Voirin N, Berthiller J, Benhaim-Luzon V, Boniol M, Straif K, Ayoub WB, et al. Risk of lung cancer and past use of cannabis in Tunisia. Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. 2006;1(6):577-9.

Hashibe M, Morgenstern H, Cui Y, Tashkin DP, Zhang ZF, Cozen W, et al. Marijuana use and the risk of lung and upper aerodigestive tract cancers: results of a population-based case-control study. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2006;15(10):1829-34.

Hsairi M, Achour N, Zouari B, Ben Romdhane H, Achour A, Maalej M, et al. [Etiologic factors in primary bronchial carcinoma in Tunisia]. La Tunisie medicale. 1993;71(5):265-8.

Sridhar KS, Raub WA, Jr., Weatherby NL, Metsch LR, Surratt HL, Inciardi JA, et al. Possible role of marijuana smoking as a carcinogen in the development of lung cancer at a young age. Journal of psychoactive drugs. 1994;26(3):285-8.

Fung M, Gallagher C, Machtay M. Lung and aero-digestive cancers in young marijuana smokers. Tumori. 1999;85(2):140-2.

Sasco AJ, Merrill RM, Dari I, Benhaim-Luzon V, Carriot F, Cann CI, et al. A case-control study of lung cancer in Casablanca, Morocco. Cancer causes & control : CCC. 2002;13(7):609-16.

Fligiel SE, Roth MD, Kleerup EC, Barsky SH, Simmons MS, Tashkin DP. Tracheobronchial histopathology in habitual smokers of cocaine, marijuana, and/or tobacco. Chest. 1997;112(2):319-26.

Gong H, Jr., Fligiel S, Tashkin DP, Barbers RG. Tracheobronchial changes in habitual, heavy smokers of marijuana with and without tobacco. The American review of respiratory disease. 1987;136(1):142-9.

Barsky SH, Roth MD, Kleerup EC, Simmons M, Tashkin DP. Histopathologic and molecular alterations in bronchial epithelium in habitual smokers of marijuana, cocaine, and/or tobacco. Journal of the National Cancer Institute. 1998;90(16):1198-205.

Busch FW, Seid DA, Wei ET. Mutagenic activity of marihuana smoke condensates. Cancer letters. 1979;6(6):319-24.

Roy PE, Magnan-Lapointe F, Huy ND, Boutet M. Chronic inhalation of marijuana and tobacco in dogs: pulmonary pathology. Research communications in chemical pathology and pharmacology. 1976;14(2):305-17.

Zhu LX, Sharma S, Stolina M, Gardner B, Roth MD, Tashkin DP, et al. Delta-9-tetrahydrocannabinol inhibits antitumor immunity by a CB2 receptor-mediated, cytokine-dependent pathway. Journal of immunology (Baltimore, Md : 1950). 2000;165(1):373-80.

Hoffmann D, Brunnemann K, Gori G, Wynder E. On the carcinogenicity of marijuana smoke. Recent Advances in Phytochemistry: Springer; 1975. p. 63-81.

Galve-Roperh I, Sanchez C, Cortes ML, Gomez del Pulgar T, Izquierdo M, Guzman M. Anti-tumoral action of cannabinoids: involvement of sustained ceramide accumulation and extracellular signal-regulated kinase activation. Nature medicine. 2000;6(3):313-9.

Hart S, Fischer OM, Ullrich A. Cannabinoids induce cancer cell proliferation via tumor necrosis factor alpha-converting enzyme (TACE/ADAM17)-mediated transactivation of the epidermal growth factor receptor. Cancer research. 2004;64(6):1943-50.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of internal medicine. 2009;151(4):264-9.

Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Jama. 2000;283(15):2008-12.

Wells G, Shea B, O’connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2000.

Zhang LR, Morgenstern H, Greenland S, Chang SC, Lazarus P, Teare MD, et al. Cannabis smoking and lung cancer risk: Pooled analysis in the International Lung Cancer Consortium. International journal of cancer Journal international du cancer. 2014.

Wang Y, McKay JD, Rafnar T, Wang Z, Timofeeva MN, Broderick P, et al. Rare variants of large effect in BRCA2 and CHEK2 affect risk of lung cancer. 2014;46(7):736-41.

Gallagher CJ, Muscat JE, Hicks AN, Zheng Y, Dyer A-M, Chase GA, et al. The UDP-glucuronosyltransferase 2B17 gene deletion polymorphism: sex-specific association with urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol glucuronidation phenotype and risk for lung cancer. Cancer Epidemiology Biomarkers & Prevention. 2007;16(4):823-8.

PJW R. Resource for the Study of Lung Cancer Epidemiology in North Trent.vol. 2013, 2009, 45.

Han B, Gfroerer JC, Colliver JD. Associations Between Duration of Illicit Drug Use and Health Conditions: Results from the 2005–2007 National Surveys on Drug Use and Health. Annals of Epidemiology.20(4):289-97.

Berthiller J, Straif K, Boniol M, Voirin N, Benhaim-Luzon V, Ayoub WB, et al. Cannabis smoking and risk of lung cancer in men: a pooled analysis of three studies in Maghreb. Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. 2008;3(12):1398-403.

Sidney S, Quesenberry CP, Jr., Friedman GD, Tekawa IS. Marijuana use and cancer incidence (California, United States). Cancer causes & control : CCC. 1997;8(5):722-8.

Roth MD, Arora A, Barsky SH, Kleerup EC, Simmons M, Tashkin DP. Airway inflammation in young marijuana and tobacco smokers. American journal of respiratory and critical care medicine. 1998;157(3 Pt 1):928-37.

Leuchtenberger C, Leuchtenberger R. The effects of naturally occurring metabolites (L-cysteine, vitamin C) on cultured human cells exposed to smoke of tobacco or marijuana cigarettes. Cytometry. 1984;5(4):396-402.

Underner M, Urban T, Perriot J, Peiffer G, Meurice JC. Usage du cannabis et retentissement fonctionnel respiratoire. Revue des maladies respiratoires. 2013;30(4):272-85.

Chiesara E, Cutrufello R, Rizzi R. Chromosome Damage in Heroin-Marijuana and Marijuana Addicts. In: Chambers C, Chambers P, Gitter S, editors. Toxicology in the Use, Misuse, and Abuse of Food, Drugs, and Chemicals. Archives of Toxicology. 6: Springer Berlin Heidelberg; 1983. p. 128-30.

Murison G, Chubb CB, Maeda S, Gemmell MA, Huberman E. Cannabinoids induce incomplete maturation of cultured human leukemia cells. Proceedings of the National Academy of Sciences. 1987;84(15):5414-8.

Wu T-C, Tashkin DP, Djahed B, Rose JE. Pulmonary hazards of smoking marijuana as compared with tobacco. New England Journal of Medicine. 1988;318(6):347-51.

Drugs UNOo. World drug report 2010: United Nations Publications; 2010.

Shafey O, Dolwick S, Guindon GE. Tobacco control country profiles. Atlanta: American Cancer Society. 2003;356.

Khalsa JH, Genser S, Francis H, Martin B. Clinical consequences of marijuana. The Journal of Clinical Pharmacology. 2002;42(S1):7S-10S.

Hall W, Solowij N. Adverse effects of cannabis. The Lancet. 1998;352(9140):1611-6.

Hibell B, Guttormsson U, Ahlström S, Balakireva O, Bjarnason T, Kokkevi A, et al. The 2011 ESPAD Report. Substance Use Among Students in 36 European Countries. Tukholma: The Swedish Council for Information on Alcohol and other Drugs, 2012. Viitattu 27.9. 2013.

Degenhardt L, Bucello C, Calabria B, Nelson P, Roberts A, Hall W, et al. What data are available on the extent of illicit drug use and dependence globally? Results of four systematic reviews. Drug and alcohol dependence. 2011;117(2):85-101.

Wiencke JK, Kelsey KT. Teen smoking, field cancerization, and a" critical period" hypothesis for lung cancer susceptibility. Environmental health perspectives. 2002;110(6):555.

Johnston LD, O'Malley PM, Bachman JG, Schulenberg JE. Monitoring the Future National Survey Results on Drug Use, 1975-2010. Volume I, Secondary School Students. Institute for Social Research. 2011.

Hayat MJ, Howlader N, Reichman ME, Edwards BK. Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. The Oncologist. 2007;12(1):20-37.

Holmberg L, Sandin F, Bray F, Richards M, Spicer J, Lambe M, et al. National comparisons of lung cancer survival in England, Norway and Sweden 2001–2004: differences occur early in follow-up. Thorax. 2010;65(5):436-41.

Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. International journal of cancer Journal international du cancer. 2010;127(12):2893-917.

Room R. Cannabis policy: moving beyond stalemate: Oxford University Press; 2010.




DOI: http://dx.doi.org/10.15342%2Fijms.v1i2.57

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