Post-diagnosis cannabis use and its association with health status and quality of life in cancer survivors

PURPOSE: To examine whether measures of health status and quality of life (QoL) were associated with cannabis use after cancer diagnosis. METHODS: Individuals who received care at an NCI-designated cancer center from 2018 to 2019 (n = 5,901) were invited to complete an online survey in 2022, of which 954 responded. We included 652 respondents in this study, which were weighted to represent the cancer center patient population [58.6% non-Hispanic White; 58.5% female; 51.8% ≥ 65 years]. We examined three self-rated exposures including physical health, mental health, and QoL each assessed using a single survey item with response options ranging from poor to excellent and dichotomized as 'Average or Below Average' or 'Above Average' (referent). Post-diagnosis cannabis use was self-reported as 'Yes' or 'No' (referent). Survey-weighted logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs), and to explore whether these associations differed by cancer stage, treatment status, or pre-diagnosis cannabis use. RESULTS: Most reported above average status for mental health (67.2%) and QoL (64.2%), and almost half (47.1%) reported above average physical health. Odds of post-diagnosis cannabis use were significantly higher among survivors with average or below average mental health (OR = 1.88; 95%CI = 1.13-3.11). Associations were positive but not statistically significant for physical health (OR = 1.38; 95%CI = 0.85-2.24) and QoL (OR = 1.24; 95%CI = 0.75-2.05). These associations did not significantly differ by cancer stage, treatment status, or pre-diagnosis cannabis use. CONCLUSION: Cancer survivors reporting average or below average health status or QoL had higher odds of cannabis use.