Liang Caihua, McClean Michael D, Marsit Carmen, Christensen Brock, Peters Edward, Nelson Heather H, Kelsey Karl T
Department of Community Health, Department of Pathology and Laboratory Medicine, Division of Biology and Medicine, Brown University, Providence, RI, USA.
Cancer Prev Res (Phila). 2009 Aug;2(8):759-68. doi: 10.1158/1940-6207.CAPR-09-0048. Epub 2009 Jul 28.
Cannabinoids, constituents of marijuana smoke, have been recognized to have potential antitumor properties. However, the epidemiologic evidence addressing the relationship between marijuana use and the induction of head and neck squamous cell carcinoma (HNSCC) is inconsistent and conflicting. Cases (n = 434) were patients with incident HNSCC disease from nine medical facilities in the Greater Boston, MA area between December 1999 and December 2003. Controls (n = 547) were frequency matched to cases on age (+/-3 years), gender, and town of residence, randomly selected from Massachusetts town books. A questionnaire was adopted to collect information on lifetime marijuana use (decade-specific exposures) and associations evaluated using unconditional logistic regression. After adjusting for potential confounders (including smoking and alcohol drinking), 10 to 20 years of marijuana use was associated with a significantly reduced risk of HNSCC [odds ratio (OR)(10-<20 years versus never users), 0.38; 95% confidence interval (CI), 0.22-0.67]. Among marijuana users moderate weekly use was associated with reduced risk (OR(0.5-<1.5 times versus <0.5 time), 0.52; 95% CI, 0.32-0.85). The magnitude of reduced risk was more pronounced for those who started use at an older age (OR(15-<20 years versus never users), 0.53; 95% CI, 0.30-0.95; OR(> or =20 years versus never users), 0.39; 95% CI, 0.17-0.90; P(trend) < 0.001). These inverse associations did not depend on human papillomavirus 16 antibody status. However, for the subjects who have the same level of smoking or alcohol drinking, we observed attenuated risk of HNSCC among those who use marijuana compared with those who do not. Our study suggests that moderate marijuana use is associated with reduced risk of HNSCC.
大麻素是大麻烟雾的成分，已被认为具有潜在的抗肿瘤特性。然而，关于大麻使用与头颈部鳞状细胞癌（HNSCC）诱发之间关系的流行病学证据并不一致且相互矛盾。病例（n = 434）为1999年12月至2003年12月期间来自马萨诸塞州大波士顿地区九个医疗机构的新发HNSCC疾病患者。对照（n = 547）在年龄（±3岁）、性别和居住城镇方面与病例进行频率匹配，从马萨诸塞州城镇名册中随机选取。采用问卷调查收集终生大麻使用情况（按十年特定暴露）信息，并使用无条件逻辑回归评估关联。在调整潜在混杂因素（包括吸烟和饮酒）后，使用大麻10至20年与HNSCC风险显著降低相关[比值比（OR）（10至<20年使用者与从不使用者相比），0.38；95%置信区间（CI），0.22 - 0.67]。在大麻使用者中，每周适度使用与风险降低相关（OR（0.5至<1.5次与<0.5次相比），0.52；95% CI，0.32 - 0.85）。对于那些开始使用大麻年龄较大的人，风险降低的幅度更为明显（OR（15至<20年使用者与从不使用者相比），0.53；95% CI，0.30 - 0.95；OR（≥20年使用者与从不使用者相比），0.39；95% CI，0.17 - 0.90；P（趋势）<0.001）。这些反向关联不依赖于人乳头瘤病毒16抗体状态。然而，对于吸烟或饮酒水平相同的受试者，我们观察到使用大麻者的HNSCC风险低于不使用者。我们的研究表明，适度使用大麻与HNSCC风险降低相关。
