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Obstructive sleep apnea severity and subsequent risk for cancer incidence

In vitro and animal models suggest that obstructive sleep apnea (OSA) increases cancer risk. However, the impact of OSA severity on cancer risk is poorly understood. We conducted a case-cohort study (a variant of the case-control study design), nested in a cohort of patients with a clinical diagnosi...

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Autores principales: Sillah, Arthur, Watson, Nathaniel F., Gozal, David, Phipps, Amanda I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525275/
https://www.ncbi.nlm.nih.gov/pubmed/31193286
http://dx.doi.org/10.1016/j.pmedr.2019.100886
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author Sillah, Arthur
Watson, Nathaniel F.
Gozal, David
Phipps, Amanda I.
author_facet Sillah, Arthur
Watson, Nathaniel F.
Gozal, David
Phipps, Amanda I.
author_sort Sillah, Arthur
collection PubMed
description In vitro and animal models suggest that obstructive sleep apnea (OSA) increases cancer risk. However, the impact of OSA severity on cancer risk is poorly understood. We conducted a case-cohort study (a variant of the case-control study design), nested in a cohort of patients with a clinical diagnosis of OSA. OSA patients diagnosed between 2005 and 2013 were linked to a population-based cancer registry to identify cancers diagnosed subsequent to OSA between 2005 and 2015. Medical records were reviewed for a representative sample of 1162 OSA patients from this cohort (including 24 with subsequent cancer), and for an additional 304 OSA patients diagnosed with cancer; information regarding OSA severity indicators, including apnea-hypopnea index (AHI) was abstracted from these records. Adjusted Cox proportional hazards regression were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for associations of OSA severity indicators on cancer incidence. Compared with individuals in the lowest AHI category (5–14.9), indicating mild OSA, the adjusted HR (95% CI) for cancer incidence associated with having moderate (15–29.9) or severe (30+) OSA were 0.72 (0.40–1.29) and 0.87 (0.52–1.45) respectively. Associations with other severity indicators were not significantly associated with cancer. However, the proportion of patients with severe OSA (AHI ≥30) was consistently higher across numerous cancer sites relative to the subcohort, suggesting increased cancer risk relative to patients with less severe OSA. The absence of significant associations with OSA severity measures suggest that the underlying mechanisms deserve further investigation.
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spelling pubmed-65252752019-05-24 Obstructive sleep apnea severity and subsequent risk for cancer incidence Sillah, Arthur Watson, Nathaniel F. Gozal, David Phipps, Amanda I. Prev Med Rep Regular Article In vitro and animal models suggest that obstructive sleep apnea (OSA) increases cancer risk. However, the impact of OSA severity on cancer risk is poorly understood. We conducted a case-cohort study (a variant of the case-control study design), nested in a cohort of patients with a clinical diagnosis of OSA. OSA patients diagnosed between 2005 and 2013 were linked to a population-based cancer registry to identify cancers diagnosed subsequent to OSA between 2005 and 2015. Medical records were reviewed for a representative sample of 1162 OSA patients from this cohort (including 24 with subsequent cancer), and for an additional 304 OSA patients diagnosed with cancer; information regarding OSA severity indicators, including apnea-hypopnea index (AHI) was abstracted from these records. Adjusted Cox proportional hazards regression were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for associations of OSA severity indicators on cancer incidence. Compared with individuals in the lowest AHI category (5–14.9), indicating mild OSA, the adjusted HR (95% CI) for cancer incidence associated with having moderate (15–29.9) or severe (30+) OSA were 0.72 (0.40–1.29) and 0.87 (0.52–1.45) respectively. Associations with other severity indicators were not significantly associated with cancer. However, the proportion of patients with severe OSA (AHI ≥30) was consistently higher across numerous cancer sites relative to the subcohort, suggesting increased cancer risk relative to patients with less severe OSA. The absence of significant associations with OSA severity measures suggest that the underlying mechanisms deserve further investigation. Elsevier 2019-05-02 /pmc/articles/PMC6525275/ /pubmed/31193286 http://dx.doi.org/10.1016/j.pmedr.2019.100886 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Regular Article
Sillah, Arthur
Watson, Nathaniel F.
Gozal, David
Phipps, Amanda I.
Obstructive sleep apnea severity and subsequent risk for cancer incidence
title Obstructive sleep apnea severity and subsequent risk for cancer incidence
title_full Obstructive sleep apnea severity and subsequent risk for cancer incidence
title_fullStr Obstructive sleep apnea severity and subsequent risk for cancer incidence
title_full_unstemmed Obstructive sleep apnea severity and subsequent risk for cancer incidence
title_short Obstructive sleep apnea severity and subsequent risk for cancer incidence
title_sort obstructive sleep apnea severity and subsequent risk for cancer incidence
topic Regular Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525275/
https://www.ncbi.nlm.nih.gov/pubmed/31193286
http://dx.doi.org/10.1016/j.pmedr.2019.100886
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