Marijuana use and risk of lung cancer: a 40-year cohort study
Marijuana use and risk of lung cancer: a 40-year cohort study
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DOI：
10.1007/s10552-013-0259-0
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发表时间：
2013-10-01
影响因子：
2.3
通讯作者：
Sidorchuk, Anna
中科院分区：
文献类型：
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作者：
Callaghan, Russell C.;Allebeck, Peter;Sidorchuk, Anna
大麻(大麻)烟雾和烟草烟雾含有许多相同的强致癌物质，但一个关键的、但尚未解决的医疗和公共卫生问题是，吸食大麻是否会促进肺癌的发展。目前的研究旨在评估年轻的大麻使用者患肺癌的风险。一项基于人群的队列研究调查了1969-1970年瑞典征兵期间18-20岁的男性(n=49,321)的大麻使用情况和其他相关变量。参与者在2009年之前在全国相关的医疗登记中被跟踪调查肺癌事件的结果。考克斯回归模型评估了在征兵时测量的吸食大麻与随后被诊断为肺癌的风险之间的关系。在基线征兵评估中，10.5%(n=5,156)的人报告一生使用大麻，1.7%(n=831)的人一生使用大麻超过50次，被指定为“大量”使用。COX回归分析(n=44,284)发现，即使在对基线烟草使用、酒精使用、呼吸状况和社会经济状况进行统计调整后，在40年的随访期内，这种“大量”吸食大麻与患肺癌的风险(风险比2.12，95%可信区间1.08-4.14)显著相关。我们的初步发现提供了初步的纵向证据，表明吸食大麻可能会增加肺癌的风险。鉴于大麻的广泛使用，特别是在青少年和年轻人中，我们的研究为在医疗、公共卫生和药物政策环境中吸食大麻的风险-益处计算提供了重要的数据。
Cannabis (marijuana) smoke and tobacco smoke contain many of the same potent carcinogens, but a critical-yet unresolved-medical and public-health issue is whether cannabis smoking might facilitate the development of lung cancer. The current study aimed to assess the risk of lung cancer among young marijuana users.A population-based cohort study examined men (n = 49,321) aged 18-20 years old assessed for cannabis use and other relevant variables during military conscription in Sweden in 1969-1970. Participants were tracked until 2009 for incident lung cancer outcomes in nationwide linked medical registries. Cox regression modeling assessed relationships between cannabis smoking, measured at conscription, and the hazard of subsequently receiving a lung cancer diagnosis.At the baseline conscription assessment, 10.5 % (n = 5,156) reported lifetime use of marijuana and 1.7 % (n = 831) indicated lifetime use of more than 50 times, designated as "heavy" use. Cox regression analyses (n = 44,284) found that such "heavy" cannabis smoking was significantly associated with more than a twofold risk (hazard ratio 2.12, 95 % CI 1.08-4.14) of developing lung cancer over the 40-year follow-up period, even after statistical adjustment for baseline tobacco use, alcohol use, respiratory conditions, and socioeconomic status.Our primary finding provides initial longitudinal evidence that cannabis use might elevate the risk of lung cancer. In light of the widespread use of marijuana, especially among adolescents and young adults, our study provides important data for informing the risk-benefit calculus of marijuana smoking in medical, public-health, and drug-policy settings.