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年轻癌症患者与医护人员讨论大麻的经历与感受:来自一家美国国立癌症研究所指定癌症中心的调查见解

Experiences and Comfort of Young Cancer Patients Discussing Cannabis with Their Providers: Insights from a Survey at an NCI-Designated Cancer Center.

作者信息

Baral Amrit, Diggs Bria-Necole A, Aka Anurag, Williams Renessa, Ortega Nicholas Hernandez, Fellah Ranya Marrakchi El, Islam Jessica Y, Camacho-Rivera Marlene, Penedo Frank J, Vidot Denise C

机构信息

Division of Epidemiology, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14 Street, Miami, FL, 33136, USA.

Sylvester Comprehensive Cancer Center, Miami, FL, USA.

出版信息

J Cancer Educ. 2025 Apr;40(2):256-265. doi: 10.1007/s13187-024-02507-9. Epub 2024 Sep 19.

Abstract

Cannabis use among cancer patients for managing treatment-related symptoms is increasing, yet little is known about patterns in patient-provider communication. This study examines demographic differences in cannabis use communication at a National Cancer Institute-designated cancer center. The analysis included cancer patients aged ≥ 18 years who self-reported current cannabis use (past 30 days) and had visited Sylvester Comprehensive Cancer Center within the past 5 years (N = 226). Data were collected via an anonymous electronic survey on REDCap. Responses on patients' disclosure of cannabis use to cancer doctor/care team and their comfort in discussing cannabis were analyzed. Chi-squared/Fisher's exact tests and t-tests were applied. Logistic regression estimated the associations between age and stage of cancer treatment with patients' comfort in discussing cannabis use with cancer doctor (oncologist). The sample was 51.8% male and 39.4% Hispanic (mean age, 45.9 years (SD = 15.1)); 41.1% were aged 20-39 years, 43.8% were undergoing treatment, and 35.4% were in follow-up/had finished treatment. Over half (50.4%) did not disclose cannabis use to their cancer doctor/care team. Non-disclosers were more often younger (20-39 years) than disclosers (52.6% vs. 29.5%, p < 0.01). Most patients (72.5%) felt comfortable discussing cannabis use with their oncologist; however, younger patients (20-39 years) were more often uncomfortable (40.8%). Logistic regression showed newly diagnosed patients had lower odds (aOR, 0.41; 95% CI, 0.12-0.98) of comfort discussing cannabis compared to those in follow-up/finished treatment. Younger patients (20-39 years) also had lower odds (aOR, 0.11; 95% CI, 0.03-0.40) of feeling comfortable discussing cannabis compared to older patients (≥ 60 years). Age and treatment stage significantly impact the cannabis use disclosure and comfort in discussing it with cancer doctor/care team. These findings underscore the importance of considering age-related factors and treatment status when addressing cannabis use discussions within oncology setting.

摘要

癌症患者使用大麻来缓解治疗相关症状的情况日益增多,但医患沟通模式却鲜为人知。本研究在一家美国国立癌症研究所指定的癌症中心,考察了大麻使用沟通方面的人口统计学差异。分析纳入了年龄≥18岁、自我报告当前(过去30天内)使用大麻且在过去5年内曾就诊于西尔维斯特综合癌症中心的癌症患者(N = 226)。数据通过REDCap上的匿名电子调查收集。对患者向癌症医生/护理团队披露大麻使用情况以及他们在讨论大麻时的舒适度的回答进行了分析。应用了卡方检验/费舍尔精确检验和t检验。逻辑回归估计了癌症治疗的年龄和阶段与患者与癌症医生(肿瘤学家)讨论大麻使用时的舒适度之间的关联。样本中男性占51.8%,西班牙裔占39.4%(平均年龄45.9岁(标准差 = 15.1));41.1%的年龄在20 - 39岁之间,43.8%正在接受治疗,35.4%处于随访/已完成治疗阶段。超过一半(50.4%)的患者未向其癌症医生/护理团队披露大麻使用情况。未披露者比披露者更年轻(20 - 39岁)(52.6%对29.5%,p < 0.01)。大多数患者(72.5%)觉得与肿瘤学家讨论大麻使用情况很自在;然而,年轻患者(20 - 39岁)往往更不自在(40.8%)。逻辑回归显示,与处于随访/已完成治疗阶段的患者相比,新诊断患者在讨论大麻使用时感到自在的几率较低(调整后比值比,0.41;95%置信区间为0.12 - 0.98)。与老年患者(≥60岁)相比,年轻患者(20 - 39岁)在讨论大麻使用时感到自在的几率也较低(调整后比值比,0.11;95%置信区间为0.03 - 0.40)。年龄和治疗阶段显著影响大麻使用情况的披露以及与癌症医生/护理团队讨论时的舒适度。这些发现强调了在肿瘤学环境中讨论大麻使用时考虑年龄相关因素和治疗状态的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef08/11978675/6e479263c6b6/13187_2024_2507_Fig1_HTML.jpg

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