Cannabis use disorder triples oral cancer risk

Dental Tribune International

Wed. 3. September 2025

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SAN DIEGO, US: As cannabis use becomes more common, its health risks remain under investigation—particularly its impact on cancer. Some users develop cannabis use disorder (CUD), a medical diagnosis for problematic cannabis use that causes significant impairment in daily life. A recent study explored the link between CUD and oral cancer. It found that people with CUD are over three times more likely to develop oral cancer within five years than people who had never used cannabis and those who used it without developing a disorder. The findings underscore potential long-term oral health risks of cannabis use and highlight the need to update oral cancer screening practices.

Dr Raphael E. Cuomo has conducted a large cohort study on associations between cannabis use disorder and oral cancer risk. (Image: Dr Raphael E. Cuomo)

Data shows that 17.7 million people in the US reported daily or near-daily cannabis use in 2022. CUD requires a formal diagnosis, and the US Centers for Disease Control and Prevention estimates that as many as three in ten cannabis users will develop CUD.

“Cannabis use is rising while its oral health implications remain understudied. Dentists are often the first clinicians to see early mucosal changes, so clarifying risk is clinically important,” study author Dr Raphael E. Cuomo, associate professor in the Department of Anesthesiology at UC San Diego School of Medicine and member of UC San Diego Moores Cancer Center, explained to Dental Tribune International.

In the study, Dr Cuomo analysed electronic health records from more than 45,000 patients, of whom 949 developed CUD. He found that individuals with CUD were 3.25 times more likely to develop oral cancer within five years than those without the disorder. Even more strikingly, tobacco smokers with CUD had a 6.24 times higher risk of developing oral cancer within the same period compared with tobacco smokers without CUD.

According to Dr Cuomo, cannabis smoke contains many of the same carcinogenic compounds found in tobacco smoke, known to damage the epithelial tissue lining the mouth. He said that the findings add to growing evidence that chronic or problematic cannabis use may increase cancer risk in tissues exposed to combustion by-products.

While more research on the long-term effects of cannabis use is needed to clarify the link between cannabis use and oral cancer, the study carries important implications for cancer screening strategies and public health messaging. In particular, it highlights the need to incorporate oral health education into substance use disorder treatment and counselling.

“Screen for cannabis use. If you know that a patient uses a high amount of cannabis, consider the patient at higher risk and perform more frequent opportunistic oral cancer examinations. Provide brief counselling and cessation support similar to tobacco and alcohol workflows, discuss avoiding combustion as harm reduction and coordinate with primary care or addiction medicine when appropriate,” Dr Cuomo recommended.

The study, titled “Cannabis use disorder and five-year risk of oral cancer in a multicenter clinical cohort”, was published online in the September 2025 issue of Preventive Medicine Reports.

Topics:

General Dentistry

Tags:

Cannabis Dental research Dental screening Oral cancer Oral health

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