• Tetyana Kendzerska, Marcus Povitz, Richard S Leung, Mark I Boulos, Daniel I McIsaac, Brian J Murray, Gregory L Bryson, Robert Talarico, John F Hilton, Atul Malhotra, and Andrea S Gershon.
• Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, Ontario, Canada. tkendzerska@toh.ca.
• Cancer Epidemiol. Biomarkers Prev. 2021 Feb 1; 30 (2): 295-304.

BackgroundTo examine the association between the severity of obstructive sleep apnea (OSA) and nocturnal hypoxemia with incident cancer.MethodsThis was a multicenter retrospective clinical cohort study using linked clinical and provincial health administrative data on consecutive adults who underwent a diagnostic sleep study between 1994 and 2017 in four academic hospitals (Canada) who were free of cancer at baseline. Cancer status was derived from the Ontario Cancer Registry. Cox cause-specific regressions were utilized to address the objective and to calculate the 10-year absolute risk difference (ARD) in the marginal probability of incident cancer and the number needed to harm (NNH).ResultsOf 33,997 individuals considered, 33,711 with no missing OSA severity were included: median age, 50 years; 58% male; and 23% with severe OSA (apnea-hypopnea index >30). Of the 18,458 individuals with information on sleep time spent with oxygen saturation (SaO2) <90%, 5% spent >30% of sleep with SaO2 <90% (severe nocturnal hypoxemia). Over a median of 7 years, 2,498 of 33,711 (7%) individuals developed cancer, with an incidence rate of 10.3 (10.0-10.8) per 1,000 person-years. Controlling for confounders, severe OSA was associated with a 15% increased hazard of developing cancer compared with no OSA (HR = 1.15, 1.02-1.30; ARD = 1.28%, 0.20-2.37; and NNH = 78). Severe hypoxemia was associated with about 30% increased hazard (HR = 1.32, 1.08-1.61; ARD = 2.38%, 0.47-4.31; and NNH = 42).ConclusionsIn a large cohort of individuals with suspected OSA free of cancer at baseline, the severity of OSA and nocturnal hypoxemia was independently associated with incident cancer.ImpactThese findings suggest the need for more targeted cancer risk awareness in individuals with OSA.©2020 American Association for Cancer Research.

17 keywords...

hide…