Cannabis Use Disorder in Patients With Lung Cancer: Study Identifies Prevalence, Outcomes

Patients with lung cancer who have cannabis use disorder tend to be admitted to the hospital at younger ages, have longer hospital stays, and incur elevated health care costs, according to a recent study.

Presented by Naga Vamsi Krishna Machineni, MD, of Johns Hopkins University, during the American Thoracic Society 2024 International Conference, the study provided insights into the outcomes of patients with cannabis use disorder who developed lung cancer.

Dr. Machineni and colleagues identified adults with lung cancer who had cannabis use disorder by using the National Inpatient Sample datasets from 2016 to 2020. The primary outcome of the study was the prevalence and trends of cannabis use disorder and its impact on major adverse cardiac and cerebrovascular events (MACCE), in-hospital mortality, and respiratory failure. Secondary outcomes included the impact of health care resource utilization and cost.

Characteristics of Patients With Lung Cancer, Cannabis Use Disorder

The researchers identified 1,683,390 patients with lung cancer in the datasets, finding that 6460 (0.4%) had cannabis use disorder. The median age at hospital admission for lung cancer was younger in patients with cannabis use disorder (59 years) than in those without cannabis use disorder (70 years; P<.001).

Patients with cannabis use disorder were also more likely to be male (68.9%) than female (31.1%), while the split between male and female patients was more even (51.7% vs 48.3%, respectively) in patients without cannabis use disorder. Patients who were Black represented 13.0% of lung cancer cases in those who did not have cannabis use disorder but represented nearly one-third (32.5%) of lung cancer case in those who had cannabis use disorder.

Patients with cannabis use disorder also had more comorbidities, with 99.8% of patients with cannabis use disorder reporting drug use, compared with 2.0% of those who did not have cannabis use disorder. In addition, more patients with cannabis use disorder reported alcohol abuse (24.1% vs 3.5%) and chronic pulmonary disease (56.5% vs 52.0%) than those without cannabis use disorder.

Outcomes of Patients With Lung Cancer, Cannabis Use Disorder

There was a statistically significant linear trend (P<.001) in respiratory failure in patients with cannabis use disorder, but the adjusted odds ratios for all-cause mortality, in-hospital mortality, MACCE, and respiratory failure were nonsignificant. However, patients with cannabis use disorder demonstrated lower rates of MACCE (11.5%) than those without cannabis use disorder (14.4%).

Patients with cannabis use disorder also experienced longer hospital stays, with a median of 5 days compared with 4 days in those without cannabis use disorder (P<.001). In addition, patients with cannabis use disorder had higher health care costs, averaging $56,876, nearly $10,000 higher than the cost of $47,647 in those without cannabis use disorder.

Dr. Machineni and colleagues concluded by reflecting on the results and implications of the study of cannabis use disorder in patients with lung cancer.

“This study underscores the association between [cannabis use disorder] and increased trends of respiratory failure, longer hospital stays, and elevated health care costs in lung cancer patients,” the study authors wrote. “Additionally, our findings indicate lower rates of MACCE in lung cancer patients with [cannabis use disorder.]”

Reference

Machineni N, Shastri D, Vutukuru S, et al. Prevalence, trends, and impact of cannabis use disorder on hospitalization outcomes of lung cancer patients: a nationwide perspective 2016-2020. Presented at the American Thoracic Society 2024 International Conference; May 17-22, 2024; San Diego, California.