• Chest · Dec 2020

    Multicenter Study

    Association between nocturnal hypoxemia and cancer incidence in patients investigated for obstructive sleep apnea. Data from a large multicenter French cohort.

    • Grégoire Justeau, Chloé Gervès-Pinquié, Marc Le Vaillant, Wojciech Trzepizur, Nicole Meslier, François Goupil, Thierry Pigeanne, Sandrine Launois, Laurene Leclair-Visonneau, Philippe Masson, Acya Bizieux-Thaminy, Marie-Pierre Humeau, Christelle Gosselin, Margaux Blanchard, Thierry Urban, Frédéric Gagnadoux, and ERMES Study Group.
    • Department of Respiratory and Sleep Medicine, Angers University Hospital, Angers.
    • Chest. 2020 Dec 1; 158 (6): 2610-2620.

    BackgroundPrevious studies have yielded inconsistent findings regarding the association between OSA and cancer in humans.Research QuestionIs there an association between indexes of sleep-disordered breathing severity and cancer incidence in patients investigated for suspected OSA?Study Design And MethodsData 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.ResultsAfter 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.InterpretationNocturnal hypoxemia was associated with all-cancer incidence in patients investigated for OSA. Whether OSA therapy might reduce the risk of cancer needs further evaluation.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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