Park Marn Joon, Kim Gyu Tae, Kang Seo Jun, Han Kyung-Do, Cho Jae Hoon, Choi Ji Ho
Department of Otorhinolaryngology-Head and Neck Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
J Rhinol. 2025 Mar;32(1):48-54. doi: 10.18787/jr.2025.00012. Epub 2025 Mar 21.
Obstructive sleep apnea (OSA) has been associated with an increased risk of cancer in various organs. OSA is also linked to chronic inflammation in the biliary tract and pancreas, a well-established risk factor for carcinogenesis in these organs. However, its relationship with biliary tract and pancreatic cancers remains unclear and has been rarely investigated. Therefore, we aimed to evaluate whether OSA serves as an independent risk factor for these malignancies by analyzing a nationwide healthcare claims database in South Korea.
A retrospective cohort study was conducted using the Korean National Health Insurance Service (KNHIS) database. Adults aged ≥20 years who were newly diagnosed with OSA (ICD-10: G47.30) between 2007 and 2014 were identified and propensity score-matched (1:5) with controls based on age, sex, and comorbidities. Individuals with pre-existing cancer diagnoses were excluded. The primary endpoints were the incidence of overall cancer, biliary tract cancer (C23-C24), and pancreatic cancer (C25). Cox proportional hazards regression models were used to calculate hazard ratios (HRs), adjusting for demographic and clinical factors.
A total of 1,191,444 individuals were included, comprising 198,574 patients diagnosed with OSA and 992,870 matched controls. OSA was associated with an increased overall cancer incidence (HR, 1.132; 95% confidence interval [CI], 1.097-1.169); however, it was not significantly associated with pancreatic cancer (HR, 0.941; 95% CI, 0.823-1.072) or biliary tract cancer (HR, 0.931; 95% CI, 0.751-1.142). Subgroup analyses stratified by sex and age revealed no statistically significant associations across these groups.
Our findings do not support OSA as an independent risk factor for biliary tract or pancreatic cancers.
阻塞性睡眠呼吸暂停（OSA）与多种器官患癌风险增加有关。OSA还与胆道和胰腺的慢性炎症相关，而慢性炎症是这些器官发生癌变的一个公认风险因素。然而，其与胆道癌和胰腺癌的关系仍不明确，且很少被研究。因此，我们旨在通过分析韩国全国性医疗保健理赔数据库来评估OSA是否是这些恶性肿瘤的独立风险因素。
使用韩国国民健康保险服务（KNHIS）数据库进行一项回顾性队列研究。确定2007年至2014年间新诊断为OSA（国际疾病分类第十版：G47.30）的年龄≥20岁的成年人，并根据年龄、性别和合并症与对照组进行倾向得分匹配（1:5）。排除已有癌症诊断的个体。主要终点是总体癌症、胆道癌（C23 - C24）和胰腺癌（C25）的发病率。使用Cox比例风险回归模型计算风险比（HRs），并对人口统计学和临床因素进行调整。
共纳入1,191,444人，其中198,574例被诊断为OSA的患者和992,870例匹配的对照组。OSA与总体癌症发病率增加相关（HR，1.132；95%置信区间[CI]，1.097 - 1.169）；然而，它与胰腺癌（HR，0.941；95% CI，0.823 - 1.072）或胆道癌（HR，0.931；95% CI，0.751 - 1.142）无显著关联。按性别和年龄分层的亚组分析显示，这些组之间无统计学显著关联。
我们的研究结果不支持OSA是胆道癌或胰腺癌的独立风险因素。
