Cancer and obstructive sleep apnea

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Cancer and Obstructive Sleep Apnea (n=32100000). Intervention: Obstructive sleep apnea (OSA) vs. Non-OSA individuals. Primary outcome: Incidence of cancer (RR 1.53, 95% CI 1.01-2.31).

doi:10.1097/md.0000000000028930

March 11, 2022MedicineOpen Access

Cancer and obstructive sleep apnea

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Key result

Obstructive sleep apnea was associated with a significantly higher prevalence of cancer compared to non-OSA individuals (RR 1.53, 95% CI 1.01-2.31).

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Why the study?

The relationship between cancer and obstructive sleep apnea has been debated for decades, with previous meta-analyses leading to conflicting conclusions.

Does obstructive sleep apnea increase the risk of developing cancer?

Key Points

To clarify conflicting evidence regarding the relationship and prevalence rates between cancer and obstructive sleep apnea.
Systematically searched PubMed, Embase, and the Cochrane Library for all studies addressing cancer and obstructive sleep apnea.
Identified 1,434 candidate titles and included 22 studies covering more than 32.1 million patients for quality assessment and pooled analyses.
The pooled incidence rate of obstructive sleep apnea among cancer patients was 46% (95% CI, 27% to 67%).
Cancer prevalence in individuals with obstructive sleep apnea was 1.53 times higher than in those without the condition (95% CI, 1.01 to 2.31), with incidence tracking sleep apnea severity.

Study Design

Type

Meta-Analysis (n=32,100,000)

Structured PICO

Does obstructive sleep apnea increase the risk of developing cancer?

P

Population

Meta-analysis of 22 clinical studies including over 32.1 million individuals assessing the association between obstructive sleep apnea and cancer incidence.

E

Exposure

Obstructive sleep apnea (OSA) as an exposure

C

Comparator

Non-OSA individuals

O

Outcome

Overall incidence of OSA positivity in cancer patients and prevalence of cancers in OSA patientshard clinical

Main Result

Relative Risk: 1.53 (95% CI 1.01–2.31)

This meta-analysis demonstrates a high prevalence of OSA in cancer patients and a 1.53-fold increased risk of developing cancer in individuals with OSA compared to those without.

Limitations

Some studies diagnosed OSA by questionnaires, potentially overdiagnosing healthy individuals.
Inclusion of precancerous lesions (e.g., colorectal adenoma, carcinoma in situ) in some studies may have increased the calculated cancer incidence.
Small sample sizes in a portion of the included studies.
Not all included studies adjusted for confounding factors such as age, gender, obesity, smoking, or alcohol intake.
Potential publication bias due to the restriction to English-language literature.
Two studies diagnosed OSA by questionnaires, which may overdiagnose healthy individuals.
Inclusion of precancerous lesions (e.g., carcinoma in situ, colorectal adenoma) in some studies might artificially increase the incidence of cancer.
Some included studies had a small sample size.
Inter-study heterogeneity in adjusting for confounders (age, gender, obesity, smoking, alcohol).

Implication

OSA may increase cancer prevalence; leaves open causality and need for prospective trials before practice change.

Abstract

OBJECTIVE: The relationship between cancers and obstructive sleep apnea (OSA) has been discussed for decades. However, the previous meta-analysis led to opposite conclusions. To further investigate this controversial issue, we performed this systematic review and meta-analysis update. METHODS: PubMed, Embase, and the Cochrane Library were systematically searched and studies on "cancer and OSA" were all included. Two reviewers independently searched articles, extracted data, and assessed the quality of included studies. Moreover, the overall incidence of cancer and OSA in corresponding populations was calculated. RESULTS: Of the 1434 titles identified, 22 articles involving more than 32.1 million patients were included in this meta-analysis. An overall incidence of OSA positive individuals in cancer was 46 (95%CI, 27-67)%, and the prevalence of cancers in OSA patients reached 1.53 (95%CI, 1.01-2.31) times higher than non-OSA individuals. CONCLUSION: This meta-analysis indicated that there was a high prevalence of OSA in cancer patients, and individuals with OSA were more likely to develop tumors, and the incidence was related to the severity of OSA.

Discussion

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Cite This Study

A 2022 study conducted a meta-analysis in Cancer and Obstructive Sleep Apnea (n=32,100,000). Obstructive sleep apnea (OSA) vs. Non-OSA individuals was evaluated on Incidence of cancer (RR 1.53, 95% CI 1.01-2.31). Obstructive sleep apnea was associated with a significantly higher prevalence of cancer compared to non-OSA individuals (RR 1.53, 95% CI 1.01-2.31).

synapsesocial.com/papers/6a7dbe153fa445558d7d874a https://doi.org/10.1097/md.0000000000028930

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Cancer and obstructive sleep apnea

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Cancer and obstructive sleep apnea

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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