Grégoire Justeau1,2, Sebastien Bailly3, Chloé Gervès-Pinquié4, Wojciech Trzepizur1,2, Nicole Meslier1,2, François Goupil5, Thierry Pigeanne6, Sandrine Launois7, Laurene Leclair-Visonneau8, Philippe Masson9, Acya Bizieux-Thaminy10, Jean-Louis Racineux4, David Gozal11, Frédéric Gagnadoux. 1. Dept of Respiratory and Sleep Medicine, Angers University Hospital, Angers, France. 2. INSERM Unit 1063, Angers, France. 3. University Grenoble Alpes, Inserm, CHU Grenoble Alpes, HP2, Grenoble, France. 4. Pays de la Loire Respiratory Health Research Institute, Beaucouzé, France. 5. Dept of Respiratory Diseases, Le Mans General Hospital, Le Mans, France. 6. Respiratory Unit, Pôle Santé des Olonnes, Olonne sur Mer, France. 7. CEREVES Paris Jean-Jaurès, Hôpital Jean-Jaurès, Paris, France. 8. Dept of Physiology and Sleep Medicine, Nantes University Hospital, Nantes, France. 9. Dept of Respiratory Diseases, Cholet General Hospital, Cholet, France. 10. Dept of Respiratory Diseases, La Roche sur Yon General Hospital, La Roche sur Yon, France. 11. Dept of Child Health, The University of Missouri School of Medicine, Columbia, MO, USA.
Abstract
BACKGROUND: Increasing evidence suggests that obstructive sleep apnoea (OSA) contributes to cancer risk; however, limited data are available on the impact of continuous positive airway pressure (CPAP) therapy on cancer incidence. We aimed to determine whether adherence to CPAP therapy is associated with a reduction in all-cancer incidence compared with nonadherent patients with OSA. METHODS: The study relied on data collected by the multicentre Pays de la Loire Sleep Cohort study, linked to health administrative data, so as to identify new-onset cancer. We included patients who were prescribed CPAP for OSA, with no history of cancer before the diagnostic sleep study or during the first year of CPAP. Patients with documented CPAP use for ≥4 h per night were defined as adherent. Those who discontinued or used CPAP <4 h per night constituted the nonadherent group. A propensity score inverse probability of treatment weighting analysis was performed to assess the effect of CPAP adherence on cancer risk. RESULTS: After a median (interquartile range) follow-up of 5.4 (3.1-8.0) years, 437 (9.7%) out of 4499 patients developed cancer: 194 (10.7%) in the nonadherent group (n=1817) and 243 (9.1%) in adherent patients (n=2682). The final weighted model showed no significant impact of CPAP adherence on all-cause cancer risk (subdistribution hazard ratio 0.94, 95% CI 0.78-1.14). CONCLUSIONS: Adherence to CPAP therapy in OSA patients was not associated with a reduction in all-cancer incidence. Whether adherent CPAP therapy of OSA might reduce the risk of specific cancer sites should be further evaluated.
BACKGROUND: Increasing evidence suggests that obstructive sleep apnoea (OSA) contributes to cancer risk; however, limited data are available on the impact of continuous positive airway pressure (CPAP) therapy on cancer incidence. We aimed to determine whether adherence to CPAP therapy is associated with a reduction in all-cancer incidence compared with nonadherent patients with OSA. METHODS: The study relied on data collected by the multicentre Pays de la Loire Sleep Cohort study, linked to health administrative data, so as to identify new-onset cancer. We included patients who were prescribed CPAP for OSA, with no history of cancer before the diagnostic sleep study or during the first year of CPAP. Patients with documented CPAP use for ≥4 h per night were defined as adherent. Those who discontinued or used CPAP <4 h per night constituted the nonadherent group. A propensity score inverse probability of treatment weighting analysis was performed to assess the effect of CPAP adherence on cancer risk. RESULTS: After a median (interquartile range) follow-up of 5.4 (3.1-8.0) years, 437 (9.7%) out of 4499 patients developed cancer: 194 (10.7%) in the nonadherent group (n=1817) and 243 (9.1%) in adherent patients (n=2682). The final weighted model showed no significant impact of CPAP adherence on all-cause cancer risk (subdistribution hazard ratio 0.94, 95% CI 0.78-1.14). CONCLUSIONS: Adherence to CPAP therapy in OSA patients was not associated with a reduction in all-cancer incidence. Whether adherent CPAP therapy of OSA might reduce the risk of specific cancer sites should be further evaluated.