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Does cannabis elevate cancer risk?

Evidence from Mendelian randomization

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Summary

Background

Cannabis use is increasing annually but the relationship between cannabis use and cancer incidence is not uniform because of confounding factors. We aimed to assess the effect of cannabis use on cancer risk using a two-sample Mendelian randomization (MR) approach.

Methods

Secondary data analyses were performed on pooled data based on Genome-Wide Association Study (GWAS), selecting data from the ICC and UK-Biobank and 23andMeInc lifetime cannabis use and cannabis use disorder related to the substance use disorders working group from the Psychiatric Genomics Consortium, then selecting highly correlated SNPs as instrumental variables. The substance use disorders working group, iPSYCH, and deCODE GWAS data, and then highly correlated SNPs were selected as instrumental variables for two-sample Mendelian randomization analyses using inverse variance weighting, MR-Egger regression, and weighted median, respectively, to evaluate the relationship between lifetime cannabis use and nine tumors, and subsequently analyzed these results in the same way using cannabis use disorders.

Results

The risk of all cancers except breast cancer was not associated with lifetime cannabis use. Our inverse variance weighting method found that lifetime marijuana use reduced the breast cancer risk (P = 0.016, odds ratio [OR] = 0.981), and we subsequently conducted analyses of cannabis use disorders and cancer risk, which showed that cannabis use disorders elevated the risk of breast cancer (P = 0.007, OR = 1.007) as well as the risk of lung cancer (P = 0.014, OR = 1.122).

Conclusion

Large MR analyses suggest that lifetime cannabis use may reduce breast cancer risk, but cannabis use disorder exacerbates the risk of breast and lung cancer. The mechanisms responsible for this outcome remain to be investigated.

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Acknowledgements

The authors would like to thank all the researchers for their contributions to the establishment and management of the MRC IEU open GWAS project.

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Authors and Affiliations

  1. Henan University of Chinese Medicine, 450000, City Zhengzhou, China

    Dong Niu, Chenchen Li & Haoran Qu

  2. Longzi Lake Campus of Henan University of Traditional Chinese Medicine, The First Affiliated Hospital, Henan University of Chinese Medicine, 450000, City Zhengzhou, China

    Dong Niu, Chenchen Li, Haoran Qu & Yuling Zheng

  3. The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China

    Dong Niu

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  1. Dong Niu
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  2. Chenchen Li
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Correspondence to Yuling Zheng.

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All authors declare that they have no conflict of interest.

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Data availability statement

The data that support the findings of this study are openly available in the OpenGWAS database (https://gwas.mrcieu.ac.uk/datasets/).

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Niu, D., Li, C., Qu, H. et al. Does cannabis elevate cancer risk?. Wien Klin Wochenschr (2023). https://doi.org/10.1007/s00508-023-02303-3

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  • DOI: https://doi.org/10.1007/s00508-023-02303-3

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