REVIEW - The association between marijuana smoking and lung cancer: a systemic review

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Arch Intern Med. 2006 Jul 10;166(13):1359-67.

The association between marijuana smoking and lung cancer: a systematic

review.

Department of Medicine, Case Western Reserve University, Cleveland, Ohio

44106-6003, USA. mehrar@...

BACKGROUND: The association between marijuana smoking and lung cancer is

unclear, and a systematic appraisal of this relationship has yet to be

performed. Our objective was to assess the impact of marijuana smoking on

the development of premalignant lung changes and lung cancer. METHODS:

Studies assessing the impact of marijuana smoking on lung premalignant

findings and lung cancer were selected from MEDLINE, PSYCHLIT, and EMBASE

databases according to the following predefined criteria: English-language

studies of persons 18 years or older identified from 1966 to the second week

of October 2005 were included if they were research studies (ie, not

letters, reviews, editorials, or limited case studies), involved persons who

smoked marijuana, and examined premalignant or cancerous changes in the

lung. RESULTS: Nineteen studies met selection criteria. Studies that

examined lung cancer risk factors or premalignant changes in the lung found

an association of marijuana smoking with increased tar exposure, alveolar

macrophage tumoricidal dysfunction, increased oxidative stress, and

bronchial mucosal histopathologic abnormalities compared with tobacco

smokers or nonsmoking controls. Observational studies of subjects with

marijuana exposure failed to demonstrate significant associations between

marijuana smoking and lung cancer after adjusting for tobacco use. The

primary methodologic deficiencies noted include selection bias, small sample

size, limited generalizability, overall young participant age precluding

sufficient lag time for lung cancer outcome identification, and lack of

adjustment for tobacco smoking.

CONCLUSION: Given the prevalence of marijuana smoking and studies

predominantly supporting biological plausibility of an association of

marijuana smoking with lung cancer on the basis of molecular, cellular, and

histopathologic findings, physicians should advise patients regarding

potential adverse health outcomes until further rigorous studies are

performed that permit definitive conclusions.

PMID: 16832000

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=16832000

Not an MD