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Increased Risk for Cancer in Young Patients with Severe Obstructive Sleep Apnea
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A2945 - Increased Risk for Cancer in Young Patients with Severe Obstructive Sleep Apnea
Author Block: G. Pillar1, R. Brenner2, T. Etzioni1, B. Silverman3, L. Keinan-Boker3, I. Liphshiz3, N. Peled4; 1Sleep Lab, Technion, Haifa, Israel, 2Oncology, Wolfson Medical Center, Holon, Israel, 3The National Cancer Registry, Israel Ministry of Health, Jerusalem, Israel, 4Oncology, Ben Gurion University, Beer Sheba, Israel.
BACKGROUND: An increase in cancer aggressiveness was reported in obstructive sleep apnea (OSA) animal models, and in sleep deprivation or insomnia. however, there is a need for clinical evidence supporting a direct correlation between OSA and cancer incidence in humans. OBJECTIVES: To investigate whether a diagnosis of OSA or its severity affects the incidence of cancer in a large homogenous patient cohort. METHODS: We analyzed a cohort of over 5000 concurrently enrolled patients, age > 18, with suspected OSA, from a tertiary medical academic center. Patients underwent whole night polysomnography and were classified for OSA severity based on Apnea Hypopnea Index (AHI) or oxygen saturation nadir. Data on cancer incidence were obtained from the Israel National Cancer Registry. A multivariate Cox proportional-hazards analysis, adjusted for age, gender, and BMI, was performed to estimate the hazard-ratio of new cancer incidence. MEASUREMENTS AND MAIN RESULTS: Among 5243 subjects diagnosed with OSA, and a median follow-up of 5.9 years, 265 were diagnosed with cancer. The most prevalent cancers were prostate (14.7%), hematological (12.8%), urethral (9.4%), colorectal (9%), and breast (8.3%). In subjects who were diagnosed with OSA at age below 45 years (n=1533), a high AHI (>57/h) was significantly associated with cancer (HR 3.7, CI: 1.12-12.45, p=0.008). CONCLUSIONS: Patients younger than 45 with severe OSA have a significantly higher all-type cancer incidence than the general population. These results should encourage clinicians to detect and diagnose young patients with suspected OSA and to recommend cancer screening methods in this high-risk population.
Author Block: G. Pillar1, R. Brenner2, T. Etzioni1, B. Silverman3, L. Keinan-Boker3, I. Liphshiz3, N. Peled4; 1Sleep Lab, Technion, Haifa, Israel, 2Oncology, Wolfson Medical Center, Holon, Israel, 3The National Cancer Registry, Israel Ministry of Health, Jerusalem, Israel, 4Oncology, Ben Gurion University, Beer Sheba, Israel.
BACKGROUND: An increase in cancer aggressiveness was reported in obstructive sleep apnea (OSA) animal models, and in sleep deprivation or insomnia. however, there is a need for clinical evidence supporting a direct correlation between OSA and cancer incidence in humans. OBJECTIVES: To investigate whether a diagnosis of OSA or its severity affects the incidence of cancer in a large homogenous patient cohort. METHODS: We analyzed a cohort of over 5000 concurrently enrolled patients, age > 18, with suspected OSA, from a tertiary medical academic center. Patients underwent whole night polysomnography and were classified for OSA severity based on Apnea Hypopnea Index (AHI) or oxygen saturation nadir. Data on cancer incidence were obtained from the Israel National Cancer Registry. A multivariate Cox proportional-hazards analysis, adjusted for age, gender, and BMI, was performed to estimate the hazard-ratio of new cancer incidence. MEASUREMENTS AND MAIN RESULTS: Among 5243 subjects diagnosed with OSA, and a median follow-up of 5.9 years, 265 were diagnosed with cancer. The most prevalent cancers were prostate (14.7%), hematological (12.8%), urethral (9.4%), colorectal (9%), and breast (8.3%). In subjects who were diagnosed with OSA at age below 45 years (n=1533), a high AHI (>57/h) was significantly associated with cancer (HR 3.7, CI: 1.12-12.45, p=0.008). CONCLUSIONS: Patients younger than 45 with severe OSA have a significantly higher all-type cancer incidence than the general population. These results should encourage clinicians to detect and diagnose young patients with suspected OSA and to recommend cancer screening methods in this high-risk population.
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