The association of bladder cancer and Cannabis: A systematic review

Abstract

Objective: To assess the association between Cannabis use and bladder cancer. Methods: A systematic literature review was performed using studies published in electronic databases including PubMed, MEDLINE, and Google Scholar. Due to the scarcity of literature on this topic, the search was not limited to a specific design, year of publication, or human studies. The studies were screened by two reviewers in the following steps; first, the studies were discovered according to the predetermined search strategy; second, the unrelated studies and duplicates were eliminated by screening the abstracts, titles, and keywords; third, the full text of relevant and eligible papers were critically appraised and assessed for the risk of bias using the respective tool. The two review authors independently assessed the risk of bias and outcome levels using the Newcastle-Ottawa Scale for the outcomes in observational studies. Any disagreements were settled by a third party. Results: The search strategy yielded 39 research articles. After removing 21 duplicates, 18 publications were eligible for title and abstract review. Thirteen studies were found to be irrelevant and subsequently excluded. Only three full-text articles were evaluated and included in the qualitative synthesis. Conclusions: The role of Cannabis in bladder cancer has been seldom studied. The small number of studies show contradictory findings; potential carcinogenic versus protective effect. The growing interest in Cannabis use after legalization necessitates further investigations with a robust design to assess the long-term effect of Cannabis on bladder cancer.