Obstructive sleep apnea was associated with a 36% increased risk of incident breast cancer compared to patients without obstructive sleep apnea (HR 1.36).
Meta-Analysis (n=5,165,200)
Does obstructive sleep apnea increase breast cancer incidence in patients?
Obstructive sleep apnea is associated with a 36% increased risk of breast cancer incidence.
Hazard Ratio: 1.36 (95% CI 1.03–1.8)
PURPOSE: Emerging evidence from animal models suggests that intermittent hypoxia due to obstructive sleep apnea (OSA) is a risk factor for breast cancer. Despite their biological plausibility, human epidemiological studies have reported conflicting results. Therefore, we conducted a meta-analysis to delineate this relationship. METHODS: We searched the PubMed, Embase, Scopus, and Cochrane Library databases for eligible studies from inception until June 6, 2021. Two reviewers selected randomized trials or observational studies reporting the association between OSA and breast cancer incidence compared with those without OSA. Two reviewers extracted relevant data and assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and Newcastle-Ottawa Scale (NOS). We pooled the maximally covariate-adjusted hazard ratios (HRs) using a random-effects inverse variance-weighted meta-analysis and performed pre-specified subgroup analyses. RESULTS: We included six studies out of 1,707 records, comprising a combined cohort of 5,165,200 patients. All studies used the International Classification of Diseases codes to classify OSA and breast cancer. OSA patients had a 36% increased breast cancer risk (HR, 1.36; 95% confidence interval CI, 1.03-1.80; N = 6, I² = 96%) compared to those without OSA. Most studies adjusted for confounders, such as age, sex, obesity, diabetes mellitus, alcohol use, and hypertension. Subgroup analyses for studies with (1) multivariate adjustment and (2) at least five years of follow-up yielded HRs of 1.35 (95% CI, 0.98-1.87; N = 5, I² = 96%) and 1.57 (95% CI, 1.14-2.18; N = 4; I² = 90%), respectively. One Mendelian randomization study suggested a causal relationship, with a two-fold increase in the odds of breast cancer in patients with OSA. CONCLUSION: This meta-analysis suggested that OSA is a risk factor for breast cancer. Future studies should explore the dose-response relationship between OSA and breast cancer, and whether treatment may mitigate breast cancer risk or progression.
Yap et al. (Sat,) conducted a meta-analysis in Obstructive sleep apnea and breast cancer (n=5,165,200). Obstructive sleep apnea vs. Patients without obstructive sleep apnea was evaluated on Breast cancer incidence (HR 1.36, 95% CI 1.03-1.80). Obstructive sleep apnea was associated with a 36% increased risk of incident breast cancer compared to patients without obstructive sleep apnea (HR 1.36).