What is the clinical evidence from this study?

Study design: Cohort. Population: Obesity-related cancers (n=126866). Intervention: Long sleep duration (≥8 hours) and poor sleep quality vs. Shorter sleep duration and good sleep quality. Primary outcome: Incident obesity-related cancer (HR 1.08, 95% CI 1.01-1.16).

What question did this study set out to answer?

The study aims to explore how sleep duration and quality relate to the risk of developing obesity-related cancers.

April 5, 2026

Abstract 5048: The association of sleep duration and quality with obesity-related cancers: Results from the health examinees study

Key Result

Long sleep duration (≥8 hours) was significantly associated with an increased risk of obesity-related cancer (HR 1.08; 95% CI 1.01-1.16).

Key Points

The study aims to explore how sleep duration and quality relate to the risk of developing obesity-related cancers.
Data collected from the Health Examinees-Gem (HEXA-G) cohort of adults aged ≥40 years.
Sleep duration categorized into <6 hours, 6-<8 hours, and ≥8 hours; quality assessed through independent questions.
Cancer cases identified via national cancer registration data.
Cox proportional hazards models utilized to estimate hazard ratios.
Long sleep duration (≥8 hours) linked to increased risk of obesity-related cancer (HR 1.08).
Nonrestorative sleep reported 'sometimes' or 'most of the time' resulted in higher obesity-related cancer risk (HRs 1.08 and 1.11).
Long sleep duration combined with nonrestorative sleep increased risks for both all-site (HR 1.10) and obesity-related cancers (HR 1.24).
Daytime fatigue, initiation difficulty, and nighttime anxiety combined with long sleep duration also heightened cancer risk.

Study Design

Type

Cohort (n=126,866)

Multicenter

Yes

Structured PICO

Does long sleep duration and poor sleep quality increase the risk of obesity-related cancers in adults aged ≥40 years?

Population

126,866 adults aged ≥40 years from the Health Examinees-Gem (HEXA-G) cohort in Korea

Intervention

Self-reported sleep duration (categorized into <6 hours, 6-<8 hours, and ≥8 hours) and sleep quality (nonrestorative sleep, daytime fatigue, difficulty in initiating sleep, and nighttime anxiety)

Comparator

Normal sleep duration and reporting sleep quality components 'not at all'

Outcome

Incident obesity-related cancers (defined by the International Agency for Research on Cancer)hard clinical

Long sleep duration and poor sleep quality are associated with an increased risk of obesity-related cancers in Korean adults.

Main Result

Effect estimate: HR 1.08 (95% CI 1.01-1.16)

Abstract

Abstract This study aims to investigate the associations of self-reported sleep duration and quality with obesity-related cancer risk in a large-scale Korean population. This prospective cohort study utilized data from the Health Examinees-Gem (HEXA-G) cohort, comprising adults aged ≥40 years. A total of 126,866 participants who provided information on both sleep duration and quality were included in the present study. Sleep duration was self-reported at baseline and categorized into 6 hours, 6-8 hours, and ≥8 hours. Sleep quality was assessed using four independent questions, including nonrestorative sleep, daytime fatigue, difficulty in initiating sleep, and nighttime anxiety. Cancer cases were identified through national cancer registration data from the Korea Central Cancer Registry of the Korea National Cancer Center. This study adopted obesity-related cancers, defined by the International Agency for Research on Cancer. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), with follow-up beginning two years after the age at enrollment and continuing until the first cancer diagnosis, loss to follow-up, or the end of the study (December 31, 2018). During the median follow-up period of 7.3 years (range, years), 7,284 incident all-site cancer cases, including 4,113 obesity-related cancer cases, were documented. Long sleep duration (≥8 h) was significantly associated with obesity-related cancer (1.08; 1.01-1.16), marginally associated with all-site cancer (1.05; 1.00-1.11), and not associated with non-obesity-related cancer. Compared with participants reporting each sleep quality component “not at all,” those reporting nonrestorative sleep “sometimes” (1.08; 1.01-1.16) or “most of the time” (1.11; 1.01-1.22) showed higher obesity-related cancer risk; those reporting initiation difficulty “sometimes” was associated with obesity-related cancer risk (1.08; 1.01-1.16), whereas daytime fatigue and nighttime anxiety showed no significant associations. Reporting sleep ≥8 h with nonrestorative sleep (“sometimes”) increased all-site cancer (1.10; 1.01-1.20) and obesity-related cancer risk (1.24; 1.11-1.39). Reporting sleep ≥8 h with daytime fatigue increased all-site cancer (1.18; 1.06-1.31) and obesity-related cancer risk (1.19; 1.04-1.37). Reporting sleep ≥8 h with initiation difficulty increased all-site cancer (1.16; 1.04-1.30) and obesity-related cancer risk (1.26; 1.13-1.41). Long sleep duration was significantly associated with obesity-related cancer risk. Long sleep duration combined with nonrestorative sleep, daytime fatigue, initiation difficulties, or nighttime anxiety had positive associations with all-site and obesity-related cancer risks, but not with non-obesity-related cancers. Citation Format: Sinyoung Cho, Sukhong Min, Hyobin Lee, So-Yoon Lee, Daehee Kang. The association of sleep duration and quality with obesity-related cancers: Results from the health examinees study abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 5048.

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