Cannabis use disorder (CUD), marked by problematic use, is linked to psychiatric comorbidities, cognitive dysfunction, respiratory complications, and immune system dysregulation. Given that cancer outcomes depend on both biological and behavioral factors, understanding whether CUD modifies survival outcomes is of substantial clinical importance.

Emerging evidence suggests that cannabis may exert immunosuppressive effects, particularly through the modulation of T-cell function, which plays a crucial role in cancer immunosurveillance. The endocannabinoid system may also promote tumor progression, especially in gastrointestinal malignancies 

The results of this study indicate that a history of cannabis use disorder prior to colon cancer diagnosis is independently associated with an increased risk of mortality, even after adjusting for demographic and clinical confounders. These results suggest that pre-existing CUD may have a negative prognostic impact on cancer outcomes, warranting further investigation into potential biological, behavioral, and healthcare-related mechanisms.

Findings on the relationship between cannabis and cancer outcomes remain mixed and may depend heavily on patterns of use. While some preclinical studies suggest anti-tumor effects of cannabinoids such as THC , others associate chronic or high-intensity cannabis exposure with tumor progression, particularly in gastrointestinal malignancies. The endocannabinoid system is known to modulate inflammation and immune function, and cannabinoids may impair anti-tumor immunity by inhibiting T-cell proliferation, suppressing antigen presentation, and altering cytokine signaling

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