Cannabis assessment in oncology patients-evaluation survey: understanding usage patterns in a rural radiation cohort in Kentucky.

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 and 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 vs 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%) vs 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.