Background : Minnesota currently has a medical cannabis program and recently legalized recreational cannabis in 2023. Evidence suggests that cannabis may have positive effects on various aspects of a cancer patient’s quality of life. However, little is known about any differences in cannabis use between rural and urban cancer patient populations. We compared cannabis use, behaviors, attitudes, access, and associations with cancer-related symptom burden in rural versus urban Minnesotans with cancer.
Methods : We conducted a cross-sectional survey between 2021 and 2022. Study participants were adults diagnosed in 2018-2019 with cancer and treated at an academic cancer center and its community clinic affiliates in Minnesota. Participants were sent self-administered surveys. 775 surveys were completed and returned. Analysis was restricted to 688 who reported residential ZIP codes to classify them as living in urban versus rural areas based on ZIP-code level Rural Urban Commuting Area codes. Our primary outcomes were cannabis use and perceptions. Secondary outcomes included patterns of use, behavior, attitudes, and self-reported symptom burden.
Results : Of 688 participants, 54% were classified as rural and 46% as urban. Of all respondents across both groups, 60% reported never using cannabis, 56% reported cannabis use during cancer treatment, and 21% reported use since cancer diagnosis. The majority of respondents in both groups believed there are potential benefits of cannabis. Those in the urban group reported greater interest in trying medical cannabis in the future compared with rural group. The majority of respondents reported never discussing cannabis use with their healthcare provider, and even fewer reported their provider recommending cannabis to them. Both urban and rural groups reported improvement in pain, stress, insomnia, appetite, and digestion. The rural group experienced more improvement in fatigue and stress compared to the urban group. Nearly no one reported worsening of any symptoms measures after the use of cannabis.
Conclusions : Cannabis use, perceptions, and attitudes were overall similar in a cohort of rural and urban improvement after use of cannabis. While the urban cohort showed greater interest in future cannabis use, the rural cohort reported greatest benefits in relief of stress and fatigue after cannabis use, two important measures of quality of life. Our data suggest that providers rarely recommend or talk about cannabis use to cancer patients. Research Sponsor: None.