{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T01:03:56Z","timestamp":1781831036701,"version":"3.54.5"},"reference-count":291,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T00:00:00Z","timestamp":1689638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoX"],"abstract":"<jats:p>Recent European data facilitate an epidemiological investigation of the controversial cannabis\u2013cancer relationship. Of particular concern were prior findings associating high-dose cannabis use with reproductive problems and potential genetic impacts. Cancer incidence data age-standardised to the world population was obtained from the European Cancer Information System 2000\u20132020 and many European national cancer registries. Drug use data were obtained from the European Monitoring Centre for Drugs and Drug Addiction. Alcohol and tobacco consumption was sourced from the WHO. Median household income was taken from the World bank. Cancer rates in high-cannabis-use countries were significantly higher than elsewhere (\u03b2-estimate = 0.4165, p = 3.54 \u00d7 10\u2212115). Eighteen of forty-one cancers (42,675 individual rates) were significantly associated with cannabis exposure at bivariate analysis. Twenty-five cancers were linked in inverse-probability-weighted multivariate models. Temporal lagging in panel models intensified these effects. In multivariable models, cannabis was a more powerful correlate of cancer incidence than tobacco or alcohol. Reproductive toxicity was evidenced by the involvement of testis, ovary, prostate and breast cancers and because some of the myeloid and lymphoid leukaemias implicated occur in childhood, indicating inherited intergenerational genotoxicity. Cannabis is a more important carcinogen than tobacco and alcohol and fulfills epidemiological qualitative and quantitative criteria for causality for 25\/41 cancers. Reproductive and transgenerational effects are prominent. These findings confirm the clinical and epidemiological salience of cannabis as a major multigenerational community carcinogen.<\/jats:p>","DOI":"10.3390\/jox13030024","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T01:02:23Z","timestamp":1689728543000},"page":"323-385","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Cannabis- and Substance-Related Carcinogenesis in Europe: A Lagged Causal Inferential Panel Regression Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3256-720X","authenticated-orcid":false,"given":"Albert Stuart","family":"Reece","sequence":"first","affiliation":[{"name":"Division of Psychiatry, University of Western Australia, Crawley, WA 6009, Australia"},{"name":"School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellie","family":"Bennett","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, University of Western Australia, Crawley, WA 6009, Australia"},{"name":"Faculty of Health Sciences, Curtin University, 208 Kent St., Bentley, Perth, WA 6102, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary Kenneth","family":"Hulse","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, University of Western Australia, Crawley, WA 6009, Australia"},{"name":"School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1916318","DOI":"10.1001\/jamanetworkopen.2019.16318","article-title":"Association Between Marijuana Use and Risk of Cancer: A Systematic Review and Meta-analysis","volume":"2","author":"Ghasemiesfe","year":"2019","journal-title":"JAMA Netw. 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