Sleep apnea and subsequent cancer incidence

• Published in: Cancer causes & control Vol. 29; no. 10; pp. 987 - 994
• Main Authors: Sillah, Arthur, Watson, Nathaniel F., Schwartz, Stephen M., Gozal, David, Phipps, Amanda I.
• Format: Journal Article
• Language: English
• Published: Cham Springer Science + Business Media 01.10.2018; Springer International Publishing; Springer Nature B.V
• Subjects: Adult; Aged; Animal models; Apnea; Biomedical and Life Sciences; Biomedicine; Cancer; Cancer Research; Cohort Studies; Colorectal cancer; Colorectal carcinoma; Diabetes mellitus; Epidemiology; Female; Health risk assessment; Hematology; Humans; Incidence; Kidneys; Male; Melanoma; Middle Aged; Neoplasms - epidemiology; Oncology; ORIGINAL PAPER; Public Health; Registries; Retrospective Studies; Risk; Sleep; Sleep apnea; Sleep Apnea Syndromes - epidemiology; Sleep disorders; Young Adult; Intermittent hypoxia; Medical records; Sleep apnea; Cancer registry; Population health
• ISSN: 0957-5243; 1573-7225; 1573-7225
• DOI: 10.1007/s10552-018-1073-5

Purpose In vitro and animal models suggest that the physiological effects of sleep apnea could contribute to cancer risk, yet epidemiologic studies have been inconsistent. Methods We identified a cohort of adults diagnosed with sleep apnea between 2005 and 2014 using regional administrative databases. Linking this cohort to a population-based cancer registry, we identified first incident cancers diagnosed after sleep apnea diagnosis through 2015. We calculated age–sex standardized cancer incidence ratios (SIRs) to compare the observed number of cancers among those with sleep apnea with expected population estimates over a comparable period. Results Among 34,402 individuals with sleep apnea, 1,575 first incident cancers were diagnosed during follow-up (mean ± SD; 5.3 ± 2.0 years). Compared to the general population, cancer incidence (SIR 1.26, 95% CI 1.20–1.32) was elevated among sleep apnea patients. We observed significantly elevated incidence for kidney (SIR 2.24, 95% CI 1.82–2.72), melanoma (SIR 1.71, 95% CI 1.42–2.03), breast (SIR 1.43, 95% CI 1.76–2.00), and corpus uteri (SIR 2.80, 95% CI 2.24–2.47) while risk for lung (SIR 0.66, 95% CI 0.54–0.79) and colorectal cancer (SIR 0.71, 95% CI 0.56–0.89) was lower. Conclusion These findings suggest an elevated cancer burden, particularly at certain sites, among individuals with diagnosed sleep apnea. Results should be interpreted with caution due to unmeasured confounders (e.g., BMI, diabetes).