MARIJUANA USE AND THE RISKS OF LUNG AND OTHER CANCERS

大麻是美国使用最广泛的非法药物。 尽管自20世纪70年代末以来大麻的使用大幅减少， 自1992年以来，青少年和年轻人中的艾滋病发病率急剧上升。 导致这一激增的一个可能因素是， 相信有没有慢性不良健康影响的定期 吸食大麻 1996年11月，加州选民通过了 215，这将合法化大麻用于药用目的。 尽管关于大麻治疗的益处存在科学争论， 公众的看法似乎是，潜在的好处超过了 风险 尽管如此，从生物化学， 细胞、组织和动物研究提供了一种生物学上合理的 假设大麻是一个危险因素的基础， 尿道癌 然而，到目前为止，还没有流行病学 这种关联的证据，主要是因为 人类癌症的诱导/潜伏期以及 在60年代末之前，大麻在美国普通人群中的使用率。主要 拟议的5年项目的目标是估计 大麻使用对肺癌和上呼吸消化道的风险 (UAT)洛杉矶县18 - 57岁居民中的癌症。 次要目的是评估大麻的相互作用效应 和烟草使用，以估计其他因素的影响， 流行病学证据是不一致或稀疏的，并启动一个 通过获得病例的肿瘤标本和颊细胞进行分子研究 从病例和对照组中。 本研究是一项基于人群的病例对照研究， 肺癌600例，UAT癌600例（口腔癌395例， 咽，85食管，和120喉）和1,200对照。 组织学确诊病例将通过快速 南加州大学癌症监测计划的确定系统， 洛杉矶县基于人口的SEER登记。控件将被 根据预先指定的算法从邻域中选择 的病例;一个对照组将与每个病例的年龄、性别 种族/民族和邻里。 数据的主要来源是 在所有受试者家中进行个人访谈。 将收集各种因素的信息： 大麻、烟草和酒精的使用;职业和环境 暴露（例如，被动吸烟）;临床因素（例如，抑郁 和癌症家族史）;饮食和其他行为（例如，水果， 蔬菜、脂肪和补充剂）;和社会人口因素（例如， SES）。

Marijuana is the most widely used illegal drug in the United States. Although marijuana use had decreased substantially since the late 1970s, it has risen dramatically since 1992 among teenagers and young adults. One possible factor contributing to this upsurge is the widespread belief that there are no chronic adverse health effects of regular marijuana use. In November 1996, California voters passed Proposition 215, which would legalize the use of marijuana for medicinal purposes. Despite scientific debate about the benefits of marijuana treatment, the public's perception seems to be that the potential benefits outweigh the risks. Nevertheless, several lines of evidence from biochemical, cellular, tissue and animal studies provide a biologically plausible basis for the hypothesis that marijuana is a risk factor for respiratory-tract cancers. Thus far, however, there is no epidemiologic evidence for this association, primarily because of the long induction/latency of human carcinomas and the infrequent use of marijuana in the general U.S. population before the late '60s. The major objective of the proposed 5-year project is to estimate the effects of marijuana use on the risk of lung cancer and upper-aerodigestive-tract (UAT) cancers among residents of Los Angeles County, ages 18-57. Secondary objectives are to assess the interaction effects of marijuana and tobacco use, to estimate the effects of other factors for which the epidemiologic evidence is inconsistent or sparse, and to initiate a molecular study by obtaining tumor specimens for cases and buccal cells from cases and controls. The proposed design is a population-based case-control study involving 600 lung-cancer cases, 600 UAT-cancer cases (395 oral cavity and pharynx, 85 esophagus, and 120 larynx), and 1,200 controls. Histologically confirmed cases will be identified by the rapid ascertainment system of the USC Cancer Surveillance Program, a population-based SEER registry for Los Angeles County. Controls will be selected according to a prespecified algorithm from the neighborhoods of cases; one control will be matched to each case on age, sex, race/ethnicity, and neighborhood. The major source of data will be personal interviews conducted with all subjects in their homes. Information will be collected on a variety of factors: detailed history of marijuana, tobacco and alcohol use; occupational and environmental exposures (e.g., passive smoking); clinical factors (e.g., depression and family history of cancer); diet and other behaviors (e.g., fruits, vegetables, fats, and supplements); and sociodemographic factors (e.g., SES).