Department of Thoracic Oncology and Surgery, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China.
Nanshan School, Guangzhou Medical University, Guangzhou, China.
Sleep Breath. 2023 Jun;27(3):843-852. doi: 10.1007/s11325-022-02695-y. Epub 2022 Sep 21.
We aimed to study the effect of obstructive sleep apnea (OSA) on cancer risk.
We searched PubMed, Embase, and Cochrane databases for relevant studies. The qualities of included studies were assessed using Newcastle-Ottawa Scale (NOS). Unadjusted and adjusted analyses were performed. We also conducted subgroup analyses stratified by gender, severity of OSA, study design, and cancer type.
After literatures search, 18 studies were included in the present study. In the unadjusted analysis, we discovered an increased cancer risk in patients with OSA with a pooled relative risk (RR) in the OSA group of 1.49 (95% confidence interval (CI): 1.32-1.69, I = 32%, P = 0.15). In adjusted analysis, OSA correlated with cancer risk (RR: 1.36, 95% CI: 1.18-1.56, I = 54%, P < 0.01). In subgroup stratified by gender and OSA severity, OSA statistically with cancer risk in females (RR: 1.27, 95% CI: 1.06-1.51) and moderate to severe OSA groups (RR: 2.62, 95% CI: 1.64; 4.19). In subgroup stratified by study design, a trend toward statistically significant differences was observed in prospective studies (RR: 1.21, 95% CI: 0.99-1.48) and cross-sectional studies (RR: 1.81, 95% CI: 0.96-3.41). Patients with OSA in the retrospective study group had a statistically higher chance of developing cancer (RR: 1.41, 95% CI: 1.11-1.79). When stratified by cancer group, statistically significant differences was observed in many types of cancer (breast cancer: RR: 1.32, 95% CI: 1.03-1.70; central nervous system cancer: RR: 1.71, 95% CI: 1.06-2.75; kidney cancer: RR: 1.81, 95% CI: 1.20-2.74; liver cancer: RR: 1.19, 95% CI: 1.10-1.29; and pancreatic cancer: RR: 1.23, 95% CI: 1.14-1.33).
This systematic review and meta-analysis suggests that obstructive sleep apnea may increase risk of cancer.
本研究旨在探讨阻塞性睡眠呼吸暂停（OSA）对癌症风险的影响。
我们检索了 PubMed、Embase 和 Cochrane 数据库中相关研究。使用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。进行了未调整和调整分析。我们还按性别、OSA 严重程度、研究设计和癌症类型进行了亚组分析。
文献检索后，本研究纳入了 18 项研究。在未调整分析中，我们发现 OSA 患者的癌症风险增加，OSA 组的合并相对风险（RR）为 1.49（95%置信区间（CI）：1.32-1.69，I=32%，P=0.15）。在调整分析中，OSA 与癌症风险相关（RR：1.36，95%CI：1.18-1.56，I=54%，P<0.01）。按性别和 OSA 严重程度分层的亚组分析中，OSA 与女性（RR：1.27，95%CI：1.06-1.51）和中重度 OSA 组（RR：2.62，95%CI：1.64；4.19）的癌症风险相关。按研究设计分层的亚组分析中，前瞻性研究（RR：1.21，95%CI：0.99-1.48）和横断面研究（RR：1.81，95%CI：0.96-3.41）中观察到统计学趋势差异。回顾性研究组中 OSA 患者发生癌症的几率统计学上更高（RR：1.41，95%CI：1.11-1.79）。按癌症类型分层的亚组分析中，多种癌症类型（乳腺癌：RR：1.32，95%CI：1.03-1.70；中枢神经系统癌症：RR：1.71，95%CI：1.06-2.75；肾癌：RR：1.81，95%CI：1.20-2.74；肝癌：RR：1.19，95%CI：1.10-1.29；胰腺癌：RR：1.23，95%CI：1.14-1.33）存在统计学差异。
本系统评价和荟萃分析表明，阻塞性睡眠呼吸暂停可能会增加癌症风险。
