A Review of Marijuana Use and Risk of Head and Neck Cancer

Introduction

The legalization and increasing social acceptance of marijuana heightens the need for a better understanding of its potential role in the development of head and neck cancer (HNC). This study reviews the impact of marijuana use on HNC and explores the demographic and clinical characteristics and treatment outcomes of HNC in marijuana users.

Materials & Methods

An online search was conducted through the PubMed, MedLine, Cochrane Library, Web of Science, and Google Scholar databases. Exclusion criteria included abstracts, editorials, review articles, studies with insufficient information on marijuana use, and those in a non-English language. Inclusion criteria included original studies published up to 2023, marijuana use in any form, and studies focussing on oral, oropharyngeal, laryngeal, and nasopharyngeal cancers.

Results

Six case studies and fifteen case-control studies met our inclusion criteria. The case studies suggested a strong association of marijuana use with oral and oropharyngeal cancers. The patients’ ages ranged from 19 to 52 years. Thirteen were male, and six were female. About 47.3% of marijuana users had no history of tobacco use. Most were treated with radical neck dissection with radiation and chemotherapy. Four died of the disease, two were alive with the disease, and thirteen were disease-free at the time of follow-up. Six case-control studies reported a direct association of marijuana with HNC. Five studies reported marijuana as a strong risk factor for p16-positive oropharyngeal cancers and for nasopharyngeal cancer.

Conclusion

The increasing prevalence of marijuana use raises concerns about its potential role in HNC. There is limited data regarding the causal relationship between marijuana use and the development of HNC. As more states continue to allow marijuana for both medicinal and recreational usage, well-designed studies are warranted to understand the pathogenesis and potential sequelae of using this substance.