Grégoire Justeau1, Chloé Gervès-Pinquié2, Marc Le Vaillant2, Wojciech Trzepizur3, Nicole Meslier3, François Goupil4, Thierry Pigeanne5, Sandrine Launois6, Laurene Leclair-Visonneau7, Philippe Masson8, Acya Bizieux-Thaminy9, Marie-Pierre Humeau10, Christelle Gosselin2, Margaux Blanchard11, Thierry Urban1, Frédéric Gagnadoux12. 1. Department of Respiratory and Sleep Medicine, Angers University Hospital, Angers. 2. Pays de la Loire Respiratory Health Research Institute, Beaucouzé. 3. Department of Respiratory and Sleep Medicine, Angers University Hospital, Angers; INSERM Unit 1063, Angers. 4. Department of Respiratory Diseases, Le Mans General Hospital, Le Mans. 5. Respiratory Unit, Pôle santé des Olonnes, Olonne sur Mer. 6. Sleep Unit, Saint-Antoine Hospital, Paris. 7. Department of Physiology and Sleep Medicine, Nantes University Hospital, Nantes. 8. Department of Respiratory Diseases, Cholet General Hospital, Cholet. 9. Department of Respiratory Diseases, La Roche sur Yon General Hospital, La Roche sur Yon. 10. Respiratory Unit, Nouvelles Cliniques Nantaises, Nantes. 11. Ecole Supérieure d'Electronique de l'Ouest, Angers, France. 12. Department of Respiratory and Sleep Medicine, Angers University Hospital, Angers; INSERM Unit 1063, Angers. Electronic address: frgagnadoux@chu-angers.fr.
Abstract
BACKGROUND: Previous studies have yielded inconsistent findings regarding the association between OSA and cancer in humans. RESEARCH QUESTION: Is there an association between indexes of sleep-disordered breathing severity and cancer incidence in patients investigated for suspected OSA? STUDY DESIGN AND METHODS: Data from a large multicenter cohort of cancer-free patients investigated for OSA were linked to health administrative data to identify new-onset cancer. Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate the association of cancer incidence with OSA severity and nocturnal hypoxemia. RESULTS: After a median follow-up period of 5.8 years (interquartile range, 3.8-7.8), 718 of 8,748 patients (8.2%) had received a diagnosis of cancer. On unadjusted Kaplan-Meier survival analyses, cancer incidence was associated with increasing severity of OSA (log-rank test, P < .0005) and nocturnal hypoxemia (log-rank test, P < .0001 for both oxygen desaturation index and percent night time with oxygen saturation < 90% [T90]). After adjustment for anthropomorphic data, smoking and alcohol consumption, comorbid cardiac, metabolic, and respiratory diseases, marital status, type of sleep study, and study site, only T90 was associated with cancer incidence (adjusted hazard ratio, 1.33; 95% CI, 1.05-1.68 for T90 ≥ 13% vs < 0.01%; P = .02). On stratified analyses, the association between T90 and cancer appeared stronger in older patients with obesity and no adequate OSA therapy. Among the most frequent cancer sites, nocturnal hypoxemia was associated with lung and breast malignancies. INTERPRETATION: Nocturnal hypoxemia was associated with all-cancer incidence in patients investigated for OSA. Whether OSA therapy might reduce the risk of cancer needs further evaluation.
BACKGROUND: Previous studies have yielded inconsistent findings regarding the association between OSA and cancer in humans. RESEARCH QUESTION: Is there an association between indexes of sleep-disordered breathing severity and cancer incidence in patients investigated for suspected OSA? STUDY DESIGN AND METHODS: Data from a large multicenter cohort of cancer-free patients investigated for OSA were linked to health administrative data to identify new-onset cancer. Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate the association of cancer incidence with OSA severity and nocturnal hypoxemia. RESULTS: After a median follow-up period of 5.8 years (interquartile range, 3.8-7.8), 718 of 8,748 patients (8.2%) had received a diagnosis of cancer. On unadjusted Kaplan-Meier survival analyses, cancer incidence was associated with increasing severity of OSA (log-rank test, P < .0005) and nocturnal hypoxemia (log-rank test, P < .0001 for both oxygen desaturation index and percent night time with oxygen saturation < 90% [T90]). After adjustment for anthropomorphic data, smoking and alcohol consumption, comorbid cardiac, metabolic, and respiratory diseases, marital status, type of sleep study, and study site, only T90 was associated with cancer incidence (adjusted hazard ratio, 1.33; 95% CI, 1.05-1.68 for T90 ≥ 13% vs < 0.01%; P = .02). On stratified analyses, the association between T90 and cancer appeared stronger in older patients with obesity and no adequate OSA therapy. Among the most frequent cancer sites, nocturnal hypoxemia was associated with lung and breast malignancies. INTERPRETATION:Nocturnal hypoxemia was associated with all-cancer incidence in patients investigated for OSA. Whether OSA therapy might reduce the risk of cancer needs further evaluation.
Authors: Michael V Genuardi; Aman Rathore; Rachel P Ogilvie; Rebecca S DeSensi; Priya V Borker; Jared W Magnani; Sanjay R Patel Journal: Chest Date: 2021-12-13 Impact factor: 9.410
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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