0896 Obstructive Sleep Apnea Severity And Subsequent Cancer Risk. (27th April 2018)

• Record Type: Journal Article
• Authors: Sillah, A; Watson, N F; Phipps, A I
• Is Part Of: Sleep. Volume 41(2018)Supplement 1
• Page Start: A333
• Page End: A333
• Publication Date: 2018-04-27
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsy061.895
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Obstructive sleep apnea (OSA) afflicts an estimated 25 million Americans. In vitro and animal models reveal evidence suggesting that the physiological effects of OSA contribute to increased cancer risk. In contrast, little is known regarding the relationship of OSA severity with cancer. We compared cancer risk among individuals with clinically diagnosed OSA according to OSA severity Methods: We identified a cohort of adults with a diagnosis of OSA between 2005–2013 within the University of Washington Medicine System in the Seattle-Puget Sound region. We linked this cohort to a population-based cancer registry serving the same region, to identify incident cancers between 2005–2015, following OSA diagnosis. We conducted a case-cohort study (N=1, 266), nested within this cohort of OSA patients, including 328 OSA patients with a cancer diagnosis. Medical records were reviewed for included patients, for the collection of information on OSA severity and continuous positive airway pressure (CPAP) device orders. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association of OSA severity and CPAP order with cancer incidence after adjusting for key confounding variables. Results: Compared with individuals in the highest apnea-hypopnea index (AHI) category (≥30), indicating severe OSA, the adjusted HR (95% CI) for cancer associated with having mild (5–14.9), or moderate (15–29.9) OSA was 0.78 (0.48, 1.24), 0.66 (0.42, 1.05) respectively. Among those with an AHI≥15, receiving a CPAP order was not associated with cancer risk (HR=0.97 (0.18, 5.13)). Although small numbers precluded detailed analyses by cancer site, the proportion of OSA patients with severe OSA (i.e., AHI≥30) was consistently higher in participants with thyroid (80%), prostate (79%), lung (71%), kidney (67%), pancreas (67%), colorectal (64%), melanoma (63%), corpus Uteri (58%) and lymphoma (47%) cancer sites as compared to the cancer-free OSA comparison group (52%) (cancer group vs comparison, X 2 =17, pvalue <0.01). Conclusion: These results support the hypothesis that the physiological effects of severe OSA might contribute to increased cancer risk. Support (If Any): This work was supported by grant numbers R03CA201806 and P30CA015704.