Association between obstructive sleep apnoea and cancer : a cross-sectional, population-based study of the DISCOVERY cohort
Palm, Andreas ; Theorell-Haglöw, J. ; Isakson, Johan ; Ljunggren, Mirjam ; Sundh, Josefin ; Ekström, Magnus Per LU
and Grote, Ludger
(2023)
In BMJ Open
13(3).
- Abstract
Objectives Nocturnal hypoxia in obstructive sleep apnoea (OSA) is a potential risk factor for cancer. We aimed to investigate the association between OSA measures and cancer prevalence in a large national patient cohort. Design Cross-sectional study. Settings 44 sleep centres in Sweden. Participants 62 811 patients from the Swedish registry for positive airway pressure (PAP) treatment in OSA, linked to the national cancer registry and national socioeconomic data (the course of DIsease in patients reported to Swedish CPAP, Oxygen and VEntilator RegistrY cohort). Outcome measures After propensity score matching for relevant confounders (anthropometric data, comorbidities, socioeconomic status, smoking prevalence), sleep apnoea severity,... (More)
Objectives Nocturnal hypoxia in obstructive sleep apnoea (OSA) is a potential risk factor for cancer. We aimed to investigate the association between OSA measures and cancer prevalence in a large national patient cohort. Design Cross-sectional study. Settings 44 sleep centres in Sweden. Participants 62 811 patients from the Swedish registry for positive airway pressure (PAP) treatment in OSA, linked to the national cancer registry and national socioeconomic data (the course of DIsease in patients reported to Swedish CPAP, Oxygen and VEntilator RegistrY cohort). Outcome measures After propensity score matching for relevant confounders (anthropometric data, comorbidities, socioeconomic status, smoking prevalence), sleep apnoea severity, measured as Apnoea-Hypopnoea Index (AHI) or Oxygen Desaturation Index (ODI), were compared between those with and without cancer diagnosis up to 5 years prior to PAP initiation. Subgroup analysis for cancer subtype was performed. Results OSA patients with cancer (n=2093) (29.8% females, age 65.3 (SD 10.1) years, body mass index 30 (IQR 27-34) kg/m 2) had higher median AHI (n/hour) (32 (IQR 20-50) vs 30 (IQR 19-45), n/hour, p=0.002) and median ODI (n/hour) (28 (IQR 17-46) vs 26 (IQR 16-41), p<0.001) when compared with matched OSA patients without cancer. In subgroup analysis, ODI was significantly higher in OSA patients with lung cancer (N=57; 38 (21-61) vs 27 (16-43), p=0.012)), prostate cancer (N=617; 28 (17-46) vs 24, (16-39)p=0.005) and malignant melanoma (N=170; 32 (17-46) vs 25 (14-41),p=0.015). Conclusions OSA mediated intermittent hypoxia was independently associated with cancer prevalence in this large, national cohort. Future longitudinal studies are warranted to study the potential protective influence of OSA treatment on cancer incidence.
(Less)
- author
- Palm, Andreas
; Theorell-Haglöw, J.
; Isakson, Johan
; Ljunggren, Mirjam
; Sundh, Josefin
; Ekström, Magnus Per
LU
and Grote, Ludger
- organization
- publishing date
- 2023-03-03
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adult thoracic medicine, ONCOLOGY, SLEEP MEDICINE
- in
- BMJ Open
- volume
- 13
- issue
- 3
- article number
- e064501
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:36868588
- scopus:85149583682
- ISSN
- 2044-6055
- DOI
- 10.1136/bmjopen-2022-064501
- language
- English
- LU publication?
- yes
- id
- d179a964-32a2-4c0d-b956-1317dff14686
- date added to LUP
- 2023-05-22 13:03:14
- date last changed
- 2024-04-19 21:58:37
@article{d179a964-32a2-4c0d-b956-1317dff14686,
abstract = {{<p>Objectives Nocturnal hypoxia in obstructive sleep apnoea (OSA) is a potential risk factor for cancer. We aimed to investigate the association between OSA measures and cancer prevalence in a large national patient cohort. Design Cross-sectional study. Settings 44 sleep centres in Sweden. Participants 62 811 patients from the Swedish registry for positive airway pressure (PAP) treatment in OSA, linked to the national cancer registry and national socioeconomic data (the course of DIsease in patients reported to Swedish CPAP, Oxygen and VEntilator RegistrY cohort). Outcome measures After propensity score matching for relevant confounders (anthropometric data, comorbidities, socioeconomic status, smoking prevalence), sleep apnoea severity, measured as Apnoea-Hypopnoea Index (AHI) or Oxygen Desaturation Index (ODI), were compared between those with and without cancer diagnosis up to 5 years prior to PAP initiation. Subgroup analysis for cancer subtype was performed. Results OSA patients with cancer (n=2093) (29.8% females, age 65.3 (SD 10.1) years, body mass index 30 (IQR 27-34) kg/m 2) had higher median AHI (n/hour) (32 (IQR 20-50) vs 30 (IQR 19-45), n/hour, p=0.002) and median ODI (n/hour) (28 (IQR 17-46) vs 26 (IQR 16-41), p<0.001) when compared with matched OSA patients without cancer. In subgroup analysis, ODI was significantly higher in OSA patients with lung cancer (N=57; 38 (21-61) vs 27 (16-43), p=0.012)), prostate cancer (N=617; 28 (17-46) vs 24, (16-39)p=0.005) and malignant melanoma (N=170; 32 (17-46) vs 25 (14-41),p=0.015). Conclusions OSA mediated intermittent hypoxia was independently associated with cancer prevalence in this large, national cohort. Future longitudinal studies are warranted to study the potential protective influence of OSA treatment on cancer incidence.</p>}},
author = {{Palm, Andreas and Theorell-Haglöw, J. and Isakson, Johan and Ljunggren, Mirjam and Sundh, Josefin and Ekström, Magnus Per and Grote, Ludger}},
issn = {{2044-6055}},
keywords = {{Adult thoracic medicine; ONCOLOGY; SLEEP MEDICINE}},
language = {{eng}},
month = {{03}},
number = {{3}},
publisher = {{BMJ Publishing Group}},
series = {{BMJ Open}},
title = {{Association between obstructive sleep apnoea and cancer : a cross-sectional, population-based study of the DISCOVERY cohort}},
url = {{http://dx.doi.org/10.1136/bmjopen-2022-064501}},
doi = {{10.1136/bmjopen-2022-064501}},
volume = {{13}},
year = {{2023}},
}