Background: Cannabis use may introduce risks and/or benefits to cancer patient treatment and survivorship, depending on product type, composition and nature of its use. Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are two primary cannabinoids that elicit therapeutic effects, but only THC has abuse potential, highlighting the importance of patient knowledge of cannabinoid potency in patient-provider interactions and provider risk-benefit assessments. This study aims to understand factors associated with knowledge of THC or CBD potency in cannabis products among a sample of cancer patients and survivors who consumed cannabis since diagnosis.

Methods: Data were analyzed from a random sample of cancer patients and survivors using cannabis (n=343) and completed an anonymous, mixed-mode survey at Roswell Park. Survey questions asked about modes of use post-cancer diagnosis including smoking (joints/bongs/pipes/blunts), vaping (e-cigarettes/other vaping device), eating cannabis (foods/drinks), and taking orally (pills/tinctures/sublingually), and knowledge of cannabinoid potency was defined as knowing THC or CBD (mg or %) against no knowledge. Chi-square and separate multivariable logistic regression analyses for the most prevalent modes of cannabis use (smoking and eating) were examined to determine factors associated with knowledge of THC and CBD potency. Models controlled for acquisition source (informal; unlicensed seller vs formal; licensed seller), cannabis use instruction source (informal; personal vs formal; healthcare professional), current use status, and educational attainment.

Results: Prevalence of cannabis use following cancer diagnosis was 26.5% (20.9% among patients in active treatment; 29.2% among survivors). Among consumers, eating cannabis foods/drinking cannabis beverages was the most prevalent mode of delivery (58.6%), followed by smoking cannabis in joints (52.8%), vaping (30.3%), and taking oral pills, tinctures, or sublingually (29.2%). Overall, 27.2% had knowledge of THC and CBD potency of the products that they consumed. Those who smoked cannabis had the lowest rates (7.8% & 3.9%) followed by those eating cannabis foods/drinks (15.0% & 7.0%). Controlling for other factors, knowledge of THC and CBD potency showed significant associations with cannabis acquisition source, cannabis use instruction source, and current use status.

Conclusions: Overall, cancer patients and survivors who use cannabis have low levels of knowledge of THC and CBD potency. These data reinforce the need for provider awareness. Relying on patient self-report of THC and CBD potency is unlikely to provide key information that providers require to assess risks and benefits of cannabis use in relation to cancer symptom management.

Citation Format: Michelle Goulette, Nicolas J. Schlienz, Amy Case, Eric Hansen, Rebecca L. Ashare, Maciej Goniewicz, Maansi Bansal-Travers, Andrew Hyland, Danielle M. Smith. Self-reported knowledge of Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) potency in cannabis products among cancer patients and survivors: Results from a survey of cannabis consumers at an NCI-designated cancer center [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6472.