RESUMEN

BACKGROUND: We assessed patient costs associated with cannabis use during cancer treatment. METHODS: Adults treated for cancer at a large, comprehensive center completed an anonymous survey regarding their thoughts and experiences with cannabis and cancer. Bivariate and weighted multivariable logistic regression assessed clinical and sociodemographic factors associated with patient-reported out-of-pocket costs for cannabis products. RESULTS: Overall, 248 cannabis users provided data on cost and were analyzed. Median monthly out-of-pocket cost for cannabis was $80 (interquartile range = $25-$150). On regression analysis, male gender (odds ratio = 2.5, 95% confidence interval = 1.2 to 5.5, P = .026) and being 45 years of age or older (odds ratio = 7.5, 95% confidence interval = 1.9 to 30.0, P = .0042) were associated with spending $100 a month or more on cannabis. Of the 166 patients who stopped using cannabis early or used less than preferred, 28% attributed it to cost and 26% to lack of insurance coverage. CONCLUSION: Cannabis use during cancer treatment may contribute to significant out-of-pocket costs, with men and younger patients more likely to pay higher costs.

Asunto(s)

Gastos en Salud , Neoplasias , Humanos , Masculino , Femenino , Persona de Mediana Edad , Neoplasias/economía , Neoplasias/terapia , Adulto , Gastos en Salud/estadística & datos numéricos , Anciano , Marihuana Medicinal/economía , Marihuana Medicinal/uso terapéutico , Cannabis , Encuestas y Cuestionarios , Costo de Enfermedad

RESUMEN

BACKGROUND: Smoking is a risk factor for developing bladder cancer (BCa). Even though continued exposure after diagnosis may adversely affect prognosis, patients may be reluctant to disclose to their physicians that they are currently smoking, leading to inaccurate reporting of exposure and missed opportunities to deliver smoking-cessation advice and treatment in the context of cancer care. OBJECTIVE: We examined the extent of misclassification of recent smoking exposure among patients undergoing BCa surveillance. DESIGN, SETTING, AND PARTICIPANTS: A consecutive sample of 145 patients with a self-reported smoking history and prior initial diagnosis of BCa was recruited from a tertiary referral urology clinic. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Patients were asked if they had smoked a cigarette or used nicotine replacement therapy (NRT) within the past week and whether they lived with a smoker. At the same visit, we collected urine under a biospecimen protocol. We used urinary cotinine, the primary metabolite of nicotine, as an objective biomarker of recent smoking exposure. Nine patients whose urine could not be interpreted for cotinine were excluded. We calculated the smoking status misreporting rate by comparing biochemically verified smoking status (≥31.5 ng/ml vs <31.5 ng/ml) against self-reported current smoking status (yes vs no) while considering recent NRT use. RESULTS AND LIMITATIONS: Overall, 11% (15 of 136) of patients had cotinine values consistent with current smoking. Of these 15 patients, 7 reported being former smokers, resulting in a 47% misclassification rate. However, three of the seven patients who denied smoking in the past week were currently using NRT. Excluding NRT users, the misclassification rate was 33%. CONCLUSIONS: Future studies investigating the impact of postdiagnosis nicotine exposure on BCa outcomes should use biochemical verification combined with self-reported smoking exposure to classify patients accurately. PATIENT SUMMARY: Bladder cancer patients may misreport smoking exposure, thereby missing opportunities for smoking cessation.