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In the spotlight: Cancer trends in obstructive sleep apnoea

Presented by
Dr Andreas Palm, Uppsala University, Sweden
ERS 2022

A large, Swedish cohort study showed that obstructive sleep apnoea (OSA)-mediated intermittent hypoxia was related to cancer prevalence. Notably, lung cancer, prostate cancer, and malignant melanoma displayed independent associations with the number of breathing events per hour in patients with OSA.

“Nocturnal intermittent hypoxia in OSA is associated with increased prevalence of cancer,” claimed Dr Andreas Palm (Uppsala University, Sweden) [1]. The current, population-based, prospective, observational DISCOVER study assessed the relation between several OSA measures and cancer prevalence. Information on 62,811 patients who were treated with continuous positive airway pressure (CPAP) was retrieved from various Swedish registries, such as the Swedish Cancer Registry, the Swedish National Patient Registry, and the Swedish Prescribed Drug Registry [2]. In total, 44,197 CPAP-treated participants with OSA did not have a cancer diagnosis within 5 years prior to CPAP, whereas 2,093 participants did have a cancer diagnosis. Propensity score matching was performed, controlling for anthropometric data, comorbidities, and socioeconomic factors.

Participants with cancer had a higher number of breathing events per hour than those without cancer, the apnoea hypopnoea index (AHI) demonstrated (32 vs 30; P=0.002). Also, the Epworth sleepiness scale (ESS) displayed that those with cancer were slightly more sleepy than those without cancer (10.0 vs 9.6; P=0.020). Next to these findings, it was shown that participants in the highest quartile of the oxygen desaturation index were relatively more likely to have cancer (25.7% vs 20.8%; P<0.001). Interestingly, certain types of cancer were specifically linked to an increased number of events per hour on the oxygen desaturation index compared with those without cancer: lung cancer (38 vs 27 events; P=0.012); prostate cancer (28 vs 24 events; P=0.005); and malignant melanoma (32 vs 25 events; P=0.015).

Overall, Dr Palm concluded that OSA-mediated intermittent hypoxia was independently related with cancer prevalence in the current cohort study. “We aim to investigate the possible influence of OSA treatment on cancer incidence in future, longitudinal studies,” said Dr Palm at the end of his presentation.

  1. Palm A, et al. Cancer prevalence is increased in obstructive sleep apnea – the population-based DISCOVERY study. Obstructive sleep apnea consequences and management. OA2290, ERS International Congress 2022, Barcelona, Spain, 4–6 September.
  2. Palm A, et al. BMJ Open. 2020;10(11).

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