Ronen Brenner1,2, Shaye Kivity3,2, Marina Peker4, Daniel Reinhorn4, Lital Keinan-Boker5,6, Barbara Silverman5, Irena Liphsitz5, Tamara Kolitz1, Carmit Levy7, Dekel Shlomi8, Giora Pillar9,10, Nir Peled11,12. 1. Oncology Institute, Wolfson Medical Center, Holon, Israel. 2. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 3. Departments of Medicine A and C, The Dr. Pinchas Borenstein Talpiot Medical Leadership Program 2013, Sheba Medical Center, Tel-Hashomer, Israel. 4. Davidoff Cancer Center, Rabin Medical Center, Petah-Tiqwa, Israel. 5. The National Cancer Registry, Israel Ministry of Health, Jerusalem, Israel. 6. Israel Center for Disease Control, Israel Ministry of Health, Jerusalem, Israel. 7. Department of Human Genetics and Biochemistry, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 8. Clalit Health Services, Dan-Petah-Tiqwa District, Israel. 9. Rambam Medical Center, Haifa, Israel. 10. Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel. 11. Ben-Gurion University, Beer-Sheva, Israel, peled.nir@gmail.com. 12. Oncology division, The Legacy Heritage Oncology Center & Dr. Larry Norton Institute, Soroka Medical Center, Beer-Sheva, Israel, peled.nir@gmail.com.
Abstract
BACKGROUND: Several studies in animal models and human with obstructive sleep apnea syndrome (OSAS) demonstrated an increase in cancer aggressiveness and mortality. However, there is a need for further clinical evidence supporting a correlation between OSAS and cancer incidence. OBJECTIVES: To reveal whether OSAS presence and severity is correlated with cancer incidence in a large homogenous patients' cohort. METHODS: We analyzed a cohort of over 5,000 concurrently enrolled patients, age > 18, with suspected OSAS, from a tertiary medical academic center. Patients underwent whole night polysomnography, the gold standard diagnostic tool for OSAS, and were classified for severity according to the Apnea Hypopnea Index (AHI). Data on cancer incidence were obtained from the Israel National Cancer Registry. A multivariate Cox proportional-hazards analysis, adjusted for age, gender, and BMI, was performed to estimate the hazard-ratio of new cancer incidence. RESULTS: Among 5,243 subjects with a median follow-up of 5.9 years, 265 were diagnosed with cancer. The most prevalent cancers were prostate (14.7%), hematological (12.8%), urothelial (9.4%), colorectal (9%), and breast (8.3%). In subjects who were diagnosed at age below 45 years (n = 1,533), a high AHI (> 57/h) was significantly associated with cancer (HR 3.7, CI 1.12-12.45, p = 0.008). CONCLUSIONS: Patients younger than 45 with severe OSAS have a significantly higher all-type cancer incidence than the general population. These results should encourage clinicians to detect and diagnose young patients with suspected OSAS and to recommend cancer screening methods in this high-risk population.
BACKGROUND: Several studies in animal models and human with obstructive sleep apnea syndrome (OSAS) demonstrated an increase in cancer aggressiveness and mortality. However, there is a need for further clinical evidence supporting a correlation between OSAS and cancer incidence. OBJECTIVES: To reveal whether OSAS presence and severity is correlated with cancer incidence in a large homogenous patients' cohort. METHODS: We analyzed a cohort of over 5,000 concurrently enrolled patients, age > 18, with suspected OSAS, from a tertiary medical academic center. Patients underwent whole night polysomnography, the gold standard diagnostic tool for OSAS, and were classified for severity according to the Apnea Hypopnea Index (AHI). Data on cancer incidence were obtained from the Israel National Cancer Registry. A multivariate Cox proportional-hazards analysis, adjusted for age, gender, and BMI, was performed to estimate the hazard-ratio of new cancer incidence. RESULTS: Among 5,243 subjects with a median follow-up of 5.9 years, 265 were diagnosed with cancer. The most prevalent cancers were prostate (14.7%), hematological (12.8%), urothelial (9.4%), colorectal (9%), and breast (8.3%). In subjects who were diagnosed at age below 45 years (n = 1,533), a high AHI (> 57/h) was significantly associated with cancer (HR 3.7, CI 1.12-12.45, p = 0.008). CONCLUSIONS:Patients younger than 45 with severe OSAS have a significantly higher all-type cancer incidence than the general population. These results should encourage clinicians to detect and diagnose young patients with suspected OSAS and to recommend cancer screening methods in this high-risk population.
Authors: Avinoam Nevler; Samantha Z Brown; David Nauheim; Carla Portocarrero; Ulrich Rodeck; Jonathan Bassig; Christopher W Schultz; Grace A McCarthy; Harish Lavu; Theresa P Yeo; Charles J Yeo; Jonathan R Brody Journal: J Am Coll Surg Date: 2020-02-11 Impact factor: 6.113
Authors: Benjamin Kye Jyn Tan; Yao Hao Teo; Nicole Kye Wen Tan; Dominic Wei Ting Yap; Raghav Sundar; Chi Hang Lee; Anna See; Song Tar Toh Journal: J Clin Sleep Med Date: 2022-05-01 Impact factor: 4.324
Authors: Tetyana Kendzerska; Marcus Povitz; Richard S Leung; Mark I Boulos; Daniel I McIsaac; Brian J Murray; Gregory L Bryson; Robert Talarico; John F Hilton; Atul Malhotra; Andrea S Gershon Journal: Cancer Epidemiol Biomarkers Prev Date: 2020-12-02 Impact factor: 4.090
Authors: Sarah Driendl; Michael Arzt; Claudia S Zimmermann; Bettina Jung; Tobias Pukrop; Carsten A Böger; Sebastian Haferkamp; Florian Zeman; Iris M Heid; Stefan Stadler Journal: ERJ Open Res Date: 2021-05-04