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Impact of obstructive sleep apnea on cancer risk: a systematic review and meta-analysis

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Abstract

Purpose

We aimed to study the effect of obstructive sleep apnea (OSA) on cancer risk.

Methods

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.

Results

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, I2 = 32%, P = 0.15). In adjusted analysis, OSA correlated with cancer risk (RR: 1.36, 95% CI: 1.18–1.56, I2 = 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).

Conclusions

This systematic review and meta-analysis suggests that obstructive sleep apnea may increase risk of cancer.

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Data availability

All data for this systematic review and meta-analysis are fully available without restriction.

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Funding

This work was supported by China National Science Foundation (Grant No. 81871893 and No. 82022048) and Key Project of Guangzhou Scientific Research Project (Grant No. 201804020030).

Author information

Author notes

  1. Donghong Wu, Zifan Zhao, Changhui Chen, and Guanjie Lu contributed equally to this work.

Authors and Affiliations

  1. 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

    Donghong Wu, Chuqiao Wang, Jun Liu & Wenhua Liang

  2. Nanshan School, Guangzhou Medical University, Guangzhou, China

    Donghong Wu, Zifan Zhao, Changhui Chen, Sirui Gao & Jieni Shen

  3. Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China

    Guanjie Lu

  4. Southern Medical University, Guangzhou, China

    Jianxing He

  5. The First People’s Hospital of Zhaoqing, Zhaoqing, 526000, China

    Wenhua Liang

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  1. Donghong Wu
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All authors directly participated in the study and have reviewed and approved the final manuscript.

Corresponding authors

Correspondence to Jianxing He or Wenhua Liang.

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Wu, D., Zhao, Z., Chen, C. et al. Impact of obstructive sleep apnea on cancer risk: a systematic review and meta-analysis. Sleep Breath 27, 843–852 (2023). https://doi.org/10.1007/s11325-022-02695-y

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