Association of marijuana smoking with oropharyngeal and oral tongue cancers

Pooled analysis from the INHANCE consortium

Morgan A. Marks, 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 & 11 others 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

Research output: Contribution to journalArticle

26 Citations (Scopus)

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. Cancer Epidemiol Biomarkers Prev; 23(1); 160-71.

Original languageEnglish (US)
Pages (from-to)160-171
Number of pages12
JournalCancer Epidemiology Biomarkers and Prevention
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2014

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Marijuana Smoking
Tongue Neoplasms
Mouth Neoplasms
Cannabis
Oropharyngeal Neoplasms
Confidence Intervals
Tobacco
Alcohols
Anticarcinogenic Agents
Cannabinoids
Latin America
Tumor Biomarkers
Tongue
Case-Control Studies
Neck
Head
Demography
Carcinoma
Incidence

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology

Cite this

Marks, Morgan A. ; Chaturvedi, Anil K. ; Kelsey, Karl ; Straif, Kurt ; Berthiller, Julien ; Schwartz, Stephen M. ; Smith, Elaine ; Wyss, Annah ; Brennan, Paul ; Olshan, Andrew F. ; Wei, Qingyi ; Sturgis, Erich M. ; Zhang, Zuo Feng ; Morgenstern, Hal ; Muscat, Joshua ; Lazarus, Philip ; McClean, Michael ; Chen, Chu ; Vaughan, Thomas L. ; Wunsch-Filho, Victor ; Curado, Maria Paula ; Koifman, Sergio ; Matos, Elena ; Menezes, Ana ; Daudt, Alexander W. ; Fernandez, Leticia ; Posner, Marshall ; Boffetta, Paolo ; Amy Lee, Yuan Chin ; Hashibe, Mia ; D'Souza, Gypsyamber. / Association of marijuana smoking with oropharyngeal and oral tongue cancers : Pooled analysis from the INHANCE consortium. In: Cancer Epidemiology Biomarkers and Prevention. 2014 ; Vol. 23, No. 1. pp. 160-171.
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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. Cancer Epidemiol Biomarkers Prev; 23(1); 160-71.",
author = "Marks, {Morgan A.} and Chaturvedi, {Anil K.} and Karl Kelsey and Kurt Straif and Julien Berthiller and Schwartz, {Stephen M.} and Elaine Smith and Annah Wyss and Paul Brennan and Olshan, {Andrew F.} and Qingyi Wei and Sturgis, {Erich M.} and Zhang, {Zuo Feng} and Hal Morgenstern and Joshua Muscat and Philip Lazarus and Michael McClean and Chu Chen and Vaughan, {Thomas L.} and Victor Wunsch-Filho and Curado, {Maria Paula} and Sergio Koifman and Elena Matos and Ana Menezes and Daudt, {Alexander W.} and Leticia Fernandez and Marshall Posner and Paolo Boffetta and {Amy Lee}, {Yuan Chin} and Mia Hashibe and Gypsyamber D'Souza",
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Marks, MA, Chaturvedi, AK, Kelsey, K, Straif, K, Berthiller, J, Schwartz, SM, Smith, E, Wyss, A, Brennan, P, Olshan, AF, Wei, Q, Sturgis, EM, Zhang, ZF, Morgenstern, H, Muscat, J, Lazarus, P, McClean, M, Chen, C, Vaughan, TL, Wunsch-Filho, V, Curado, MP, Koifman, S, Matos, E, Menezes, A, Daudt, AW, Fernandez, L, Posner, M, Boffetta, P, Amy Lee, YC, Hashibe, M & D'Souza, G 2014, 'Association of marijuana smoking with oropharyngeal and oral tongue cancers: Pooled analysis from the INHANCE consortium', Cancer Epidemiology Biomarkers and Prevention, vol. 23, no. 1, pp. 160-171. https://doi.org/10.1158/1055-9965.EPI-13-0181

Association of marijuana smoking with oropharyngeal and oral tongue cancers : Pooled analysis from the INHANCE consortium. / Marks, Morgan A.; Chaturvedi, Anil K.; Kelsey, Karl; Straif, Kurt; Berthiller, Julien; Schwartz, Stephen M.; Smith, Elaine; Wyss, Annah; Brennan, Paul; Olshan, Andrew F.; Wei, Qingyi; Sturgis, Erich M.; Zhang, Zuo Feng; Morgenstern, Hal; Muscat, Joshua; Lazarus, Philip; McClean, Michael; Chen, Chu; Vaughan, Thomas L.; Wunsch-Filho, Victor; Curado, Maria Paula; Koifman, Sergio; Matos, Elena; Menezes, Ana; Daudt, Alexander W.; Fernandez, Leticia; Posner, Marshall; Boffetta, Paolo; Amy Lee, Yuan Chin; Hashibe, Mia; D'Souza, Gypsyamber.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 23, No. 1, 01.01.2014, p. 160-171.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association of marijuana smoking with oropharyngeal and oral tongue cancers

T2 - Pooled analysis from the INHANCE consortium

AU - Marks, Morgan A.

AU - Chaturvedi, Anil K.

AU - Kelsey, Karl

AU - Straif, Kurt

AU - Berthiller, Julien

AU - Schwartz, Stephen M.

AU - Smith, Elaine

AU - Wyss, Annah

AU - Brennan, Paul

AU - Olshan, Andrew F.

AU - Wei, Qingyi

AU - Sturgis, Erich M.

AU - Zhang, Zuo Feng

AU - Morgenstern, Hal

AU - Muscat, Joshua

AU - Lazarus, Philip

AU - McClean, Michael

AU - Chen, Chu

AU - Vaughan, Thomas L.

AU - Wunsch-Filho, Victor

AU - Curado, Maria Paula

AU - Koifman, Sergio

AU - Matos, Elena

AU - Menezes, Ana

AU - Daudt, Alexander W.

AU - Fernandez, Leticia

AU - Posner, Marshall

AU - Boffetta, Paolo

AU - Amy Lee, Yuan Chin

AU - Hashibe, Mia

AU - D'Souza, Gypsyamber

PY - 2014/1/1

Y1 - 2014/1/1

N2 - 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. Cancer Epidemiol Biomarkers Prev; 23(1); 160-71.

AB - 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. Cancer Epidemiol Biomarkers Prev; 23(1); 160-71.

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