- High prevalence of lifetime unprescribed medicinal cannabis use (51%), primarily for pain, nausea, anxiety, appetite, sleep; ≥80% reported symptom and quality of life improvement.
- Recent cannabis use rose slightly after cancer diagnosis (14.7% vs 12.7%, p=0.0625); recent users were more likely to reside in urban than rural areas.
- First fully tablet-based, staff-free oncology survey showing feasibility in rural populations and providing novel data from an opioid-endemic region, including concomitant opioid and gabapentin assessment.
Oncologist. 2026 Sep 22:oyag370. doi: 10.1093/oncolo/oyag370. Online ahead of print.
ABSTRACT
BACKGROUND: Research on self-administration of unprescribed cannabis remains limited because of its evolving legal status in the United States. We conducted, to our knowledge, the first fully independent tablet application-executed oncology survey without research staff oversight in urban and rural radiation oncology practices. Objectives were to: (1) characterize symptoms motivating cannabis use, (2) compare urban and rural patterns of use, (3) assess concomitant use with opioids and gabapentin in an opioid-endemic region, and (4) evaluate associations with patient-reported quality of life.
MATERIALS/METHODS: An IRB-approved, de-identified survey was administered to 237 adults receiving radiation therapy between July 2023 and February 2024, from an urban practice and a rural satellite of an NCI/NCCN-designated cancer center. The survey assessed demographics, symptoms, quality of life, financial toxicity, and cannabis procurement. McNemar’s test compared cannabis use before versus after cancer diagnosis; Fisher’s exact and Cochran-Mantel-Haenszel tests evaluated associations.
RESULTS: Of 237 participants, 121 (51%) reported lifetime unprescribed medicinal cannabis use. Recent use after cancer diagnosis was reported by 35 patients (14.7%) versus 30 (12.7%) before diagnosis (p = 0.0625). Users most commonly reported cannabis for pain, nausea, anxiety, depression, poor appetite, and sleep disturbance; at least 80% reported symptom and quality-of-life improvement. Recent users were more likely to reside in urban than rural areas.
CONCLUSION: Self-administration of unprescribed medicinal cannabis use was common across demographic groups and was primarily directed toward symptom management. This study demonstrates the feasibility of fully tablet-based research in rural oncology populations and provides novel data from an opioid-endemic region.
PMID:42770844 | DOI:10.1093/oncolo/oyag370
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