The effect of cannabis on prostate-specific antigen level among men in the United States: results from the National Heal
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LETTER TO THE EDITOR
The effect of cannabis on prostate‑specific antigen level among men in the United States: results from the National Health and Nutrition Examination Survey Chien‑Hsiang Weng1,2 · Daniel R. Wieland3 · Xun Luo4 · Katherine L. Webb5 · George D. Papandonatos5 Received: 4 September 2020 / Accepted: 10 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Dear Editor Cannabis, or marijuana, is one of the most commonly used illicit drugs in the United States. Fantus et al. conducted a cross-sectional study examining the effect of tetrahydrocannabinol on testosterone among men [1]. Few studies examined the association between cannabis use and prostatic health. We designed a study to characterize regular marijuana use (RMU) and its association with prostate-specific antigen (PSA) levels, a biomarker tested in men typically over the age of 50 to help screen prostate cancer [2–4] by analyzing data from the National Health and Nutrition Examination Survey (NHANES). As only the 2009–2010 NHANES survey included items about both “regular marijuana use” and “PSA level”, only cross-sectional data from this single survey year were included. Inclusion criteria were serological testing for PSA. Exclusion criteria were current infection/inflammation of the prostate, rectal exam in the last 7 days, or had a prostate biopsy/surgery/cystoscopy in the last 4 weeks. Patients with a history of any cancer or younger than 40 years old were excluded. A total of 189 participants satisfied inclusion/ Chien-Hsiang Weng and Daniel R. Wieland are both first authors of this article. * Chien‑Hsiang Weng chien‑[email protected] 1
Department of Family Medicine, Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
2
Providence Community Health Centers, Providence, RI 02905, USA
3
University of Arizona, Tucson, AZ 85721, USA
4
Department of Surgery, University Hospital Cleveland Medical Center, Cleveland, OH 44106, USA
5
Department of Biostatistics, School of Public Health, Brown University, Providence, RI 02903, USA
exclusion criteria, of which 127 were Caucasian and 62 African American. Other races were excluded due to the low sample size. Considering the distribution of PSA levels, we applied linear regression models to the natural-logtransformed PSA levels against the length of regular marijuana use, controlling for age and cigarette smoking status. All analyses were conducted using STATA 13.1 (StataCorp, College Station, Texas, USA). The median ages of first marijuana use and started RMU between the two groups were similar. The median duration of RMU was longer for African Americans at 25.5 years compared to Caucasians at 14.00 years (P = 0.006). More African Americans were current smokers at 54.8% relative to Caucasians at 38.6% within this study (P = 0.034) (Table 1). Race appeared to moderate the association between length of RMU and PSA levels (P interaction = 0.038). Length of RMU was significantly associated with higher PSA levels in African Americans (P
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