Cannabis Dependence Not Linked to Higher Cancer Mortality, Unlike Alcohol and Opioids

Among 22,763 cancer patients, cannabis dependence showed no significant association with mortality, while alcohol and opioid dependence were linked to significantly higher death rates even after adjusting for tumor stage.

Khoyilar, Shawnly et al.·Psycho-oncology·2025·ModerateRetrospective Cohort
RTHC-06821Retrospective CohortModerate2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate
Sample
Not reported

What This Study Found

Cannabis dependence was not significantly associated with mortality among cancer patients. In contrast, alcohol and opioid dependence remained significant predictors of mortality after adjusting for tumor stage. Tobacco dependence showed an attenuated association after stage adjustment, suggesting confounding by later-stage diagnosis.

Key Numbers

22,763 cancer patients; cannabis dependence not significant for mortality; alcohol and opioid dependence significant in adjusted models; tumor stage adjustment reduced opioid and tobacco hazard ratios.

How They Did This

Retrospective analysis of 22,763 cancer patients aged 18+ from UC San Diego Health. Substance dependence identified from electronic health records. Cox proportional hazards models adjusted for tumor staging (TNM system with imputed missing data).

Why This Research Matters

Cancer patients sometimes worry that cannabis use might worsen their prognosis. This large study suggests cannabis dependence, unlike alcohol or opioid dependence, does not appear to independently increase mortality risk in cancer patients.

The Bigger Picture

As more cancer patients use cannabis for symptom management, understanding whether it affects survival is critical. This study adds to evidence suggesting cannabis does not worsen cancer outcomes, though the small number of cannabis-dependent patients limits statistical power.

What This Study Doesn't Tell Us

Substance dependence from clinical notes may undercount actual use. Small sample of cannabis-dependent patients limits power. Single health system. Cannot distinguish between types/amounts of cannabis use. Observational design with potential unmeasured confounders.

Questions This Raises

  • ?Would a larger sample of cannabis-dependent cancer patients reveal a mortality signal?
  • ?Does cannabis type or consumption method matter for cancer outcomes?

Trust & Context

Key Stat:
Cannabis dependence not linked to cancer mortality
Evidence Grade:
Large retrospective cohort with tumor stage adjustment, but limited by small cannabis-dependent sample and observational design.
Study Age:
2025 publication
Original Title:
Influence of Substance Use Disorders on Mortality in a Systemwide Cohort of Cancer Patients.
Published In:
Psycho-oncology, 34(8), e70243 (2025)
Database ID:
RTHC-06821

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study
What do these levels mean? →

Frequently Asked Questions

Does cannabis use affect cancer survival?

In this study of 22,763 cancer patients, cannabis dependence was not significantly associated with mortality. However, the small number of cannabis-dependent patients means this finding should be interpreted cautiously.

Which substances are linked to worse cancer outcomes?

Alcohol and opioid dependence were significantly associated with higher cancer mortality even after accounting for tumor stage. Cannabis and amphetamine dependence were not, though both had limited sample sizes.

Read More on RethinkTHC

Cite This Study

RTHC-06821·https://rethinkthc.com/research/RTHC-06821

APA

Khoyilar, Shawnly; Purushothaman, Vidya; Cuomo, Raphael E. (2025). Influence of Substance Use Disorders on Mortality in a Systemwide Cohort of Cancer Patients.. Psycho-oncology, 34(8), e70243. https://doi.org/10.1002/pon.70243

MLA

Khoyilar, Shawnly, et al. "Influence of Substance Use Disorders on Mortality in a Systemwide Cohort of Cancer Patients.." Psycho-oncology, 2025. https://doi.org/10.1002/pon.70243

RethinkTHC

RethinkTHC Research Database. "Influence of Substance Use Disorders on Mortality in a Syste..." RTHC-06821. Retrieved from https://rethinkthc.com/research/khoyilar-2025-influence-of-substance-use

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.