Cannabis use and perceptions among rural and urban cancer patients and survivors from a Pennsylvania cancer center.

Ireland J.; Holben L.; Thompson C.; Zhu J.; Polimera H.; Truica C. · Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026

**Background & Methods** This cross-sectional survey study examined cannabis use patterns and perceptions among 186 adult cancer patients at Penn State Cancer Institute, with specific focus on comparing rural versus urban/suburban populations. Eligible participants had active cancer diagnoses and received treatment within the previous year; data were analyzed using Fisher's exact test and multivariable logistic regression controlling for residence area and sociodemographic factors. **Key Findings** - Cannabis use prevalence was 26.1% among surveyed cancer patients, with no significant differences between rural and urban/suburban populations; area of residence was not independently associated with use in multivariable analysis. - Users reported substantial symptom improvement across multiple cancer-related symptoms: insomnia (89.7%), appetite (85.7%), mood (83.7%), joint pain/stiffness (83.3%), stress/anxiety/depression (81.6%), cancer pain (80.7%), and digestive symptoms (67.9%), with consistent benefits across geographic locations. - Urban/suburban patients demonstrated significantly greater belief that cannabis helps nausea/vomiting (p=0.019), were more likely to avoid cannabis due to medication interaction concerns (p=0.002), and preferentially obtained cannabis from dispensaries rather than other sources (p=0.046). **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. The study did not systematically assess adverse effects or safety outcomes, though medication interactions were mentioned as a concern influencing urban/suburban patients' decision-making regarding use. **Evidence Quality** This study has significant limitations that restrict evidence quality. The cross-sectional design prevents causal inference regarding symptom improvement; symptom benefit could reflect recall bias, placebo effect, or confounding variables uncontrolled in analysis. The anonymous survey format may introduce selection bias, with potentially different response rates between geographic groups. The relatively small sample size (n=186) limits generalizability despite the stated focus on underrepresented rural populations. Self-reported symptom improvement without standardized outcome measures or comparison control group substantially weakens conclusions. The study provides Level 3-4 evidence (observational, descriptive) and should be considered hypothesis-generating rather than definitive. Future research requires prospective design, standardized symptom assessment tools, control groups, and systematic adverse event monitoring to establish cannabis efficacy in cancer symptom management.

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