Obstructive Sleep Apnea and Lung Cancer: A Systematic Review and Meta-Analysis

Cheong, Alex Jia Yang; Tan, Benjamin Kye Jyn; Teo, Yao Hao; Tan, Nicole Kye Wen; Yap, Dominic Wei Ting; Sia, Ching‐Hui; Ong, Thun How; Leow, Leong Chai; See, Anna; Toh, Song Tar

doi:10.1513/annalsats.202108-960oc

Cited by 34 publications

(34 citation statements)

References 35 publications

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“…Obstructive sleep apnea (OSA) is a highly prevalent disorder, with close to one billion adults suffering from OSA globally (4). While OSA has been well-established as an independent risk factor for both cardiovascular and neuropsychiatric disease (5)(6)(7)(8)(9)(10), emerging evidence has shown higher overall cancer incidence in individuals with OSA, suggesting that it could be an important risk factor for GI cancers as well (11)(12)(13)(14)(15)(16). Laboratory-based studies have shown the underlying mechanism to be related to repetitive hypoxia and reoxygenation, particularly intermittent hypoxia which is a potent enhancer of the hallmarks of cancer, such as angiogenesis, immune evasion, and metastasis (10,11,(17)(18)(19)(20)(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea and the incidence and mortality of gastrointestinal cancers: a systematic review and meta-analysis of 5,120,837 participants

Teo

Tan

et al. 2022

J Gastrointest Oncol

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Background: Emerging evidence has shown higher overall cancer incidence in patients with obstructive sleep apnea. Gastrointestinal cancers, including esophageal, stomach, liver, pancreas, and colorectal cancers account for 26% of incident cancers. However, the link between gastrointestinal cancers and obstructive sleep apnea is still unclear. We performed a systematic review and meta-analysis (registered PROSPERO CRD42021220836) to investigate the association between obstructive sleep apnea and incidence of gastrointestinal cancer. Methods:We searched four electronic databases (PubMed, Embase, Cochrane Library, Scopus) and included studies published from inception till 15th November 2020 reporting the association of obstructive sleep apnea with gastrointestinal cancer incidence. Extracted data was meta-analyzed in a random-effects model.Results: A total of seven studies were included, forming a combined cohort of 5,120,837 patients. Studies which adjusted for demographics and comorbidities were included in meta-analysis. Among four studies with 7-11 years of median follow-up, patients with obstructive sleep apnea experienced increased incidence of colorectal cancer (HR 1.70, 95% CI: 1.48-1.96, I 2 =22%). Pancreatic cancer incidence was nominally increased in three studies (HR 1.36, 95% CI: 0.88-2.09, I 2 =96), though this was not statistically significant.There was no association between obstructive sleep apnea and liver cancer incidence among three studies (HR 0.99, 95% CI: 0.81-1.22, I 2 =84). However, the lack of a statistically significant relationship between obstructive sleep apnea and pancreatic cancer in our meta-analysis does not necessarily imply the true absence of an association.

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Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea and the incidence and mortality of gastrointestinal cancers: a systematic review and meta-analysis of 5,120,837 participants

Teo

Tan

et al. 2022

J Gastrointest Oncol

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“…Previous studies have reported that OSAS is associated with lung cancer. [16][17][18][19][20][21][22] OSAS patients had higher risk of lung cancer compared with those without OSAS. 22 Intermittent nocturnal hypoxemia and sleep fragmentation were immediate consequences of OSAS, which might play a role in carcinogenesis.…”

Section: Discussionmentioning

confidence: 96%

“… 16–22 OSAS patients had higher risk of lung cancer compared with those without OSAS. 22 Intermittent nocturnal hypoxemia and sleep fragmentation were immediate consequences of OSAS, which might play a role in carcinogenesis. 18–20 And animal studies have shown that OSAS and lung cancer are linked via chronic and intermittent hypoxemia.…”

Section: Discussionmentioning

confidence: 99%

Manuscript Title: A 4-miRNAs Serum Panel for Obstructive Sleep Apnea Syndrome Screening

Mo¹,

Zeng²,

Li³

et al. 2022

NSS

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Background: Obstructive sleep apnea syndrome (OSAS) is a common chronic sleep disorder. OSAS is closely related to cardiovascular disease, metabolic disorders, cancer risk, and sudden death. This association has special significance in young people. Although it is known that OSAS has a great impact on physical health, it is estimated that 70-80% of patients with moderate-to-severe OSAS remain undiagnosed. Therefore, a new method for early diagnosis of the disease, the therapeutic effect of OSAS and prevention of complications to important. Methods: A total of 110 patients with moderate-to-severe OSAS diagnosed in the Sleep Disorders Diagnosis and Treatment Center of Peking University Shenzhen Hospital were selected. After excluding other diseases, 59 patients were finally selected as the OSAS group. In addition, 60 healthy people were selected as the control group. Serum RNA was then extracted. Eight RNA samples were randomly selected from the two groups for high-throughput miRNA sequencing. The 10 miRNAs with the greatest differences were selected as preselected markers from the results. Then, qRT-PCR was performed on the remaining RNA samples of the two groups to extract and verify the 10 miRNAs, and statistical analysis was performed between groups. Results: A diagnostic panel was constructed by a stepwise logistic regression model combined with the expression data of miRNAs in the validation phase. A four-miRNA panel was identified to better predict OSAS, and the model was calculated using the following formula: Logit (P)= 0.77-1.65 × miR-486-5p -4.56 × miR-148a-3p + 1.79 × miR-744-5p + 1.13 × let-7d-3p. The AUC for the four-miRNA panel was 0.955 (95% CI: 0.899 to 0.985; sensitivity = 91.38%, specificity = 91.38%). Gene Ontology (GO) annotation and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis was included in bioinformatic analysis. Conclusion: A 4-miRNAs panel as a diagnostic biomarker for OSAS screening is feasible.

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“…Indeed, poor general health, with depressive symptoms, low socio-economic status or high BMI, have been shown to be related with long duration of sleep [ 41 , 42 , 43 ]. In addition, two recent meta-analyses have shown that sleep-disordered breathing is an independent risk factor of lung cancer [ 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Sleep Traits, Night Shift Work and Lung Cancer Risk among Women: Results from a Population-Based Case-Control Study in France (The WELCA Study)

Cordina‐Duverger

Uchai²,

Tvardik³

et al. 2022

IJERPH

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Circadian rhythm disruption due to night shift work and/or sleep disorders is associated with negative health outcomes including cancer. There is only scant evidence of an association with lung cancer, unlike breast and prostate cancer. We explore the role of sleep disorders and night shift work in lung cancer risk among women in a population-based case-control study, including 716 lung cancer cases and 758 controls. Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) associated with sleep duration per day (<7 h, 7–7.9 h, ≥8 h), a summary index of sleep disorders, chronotype, and night shift work exposure metrics. When compared to women with an average sleep duration of 7–7.9 h per day, the OR was 1.39 (95% CI 1.04–1.86) in long sleepers (≥8 h) and 1.16 (95% CI 0.86–1.56) in short sleepers (<7 h). Overall, lung cancer was not associated with the sleep disorder index, nor with night shift work, regardless of the duration of night work or the frequency of night shifts. However, elevated OR associated with the sleep disorder index were found in the subgroup of current smokers. The U-shaped association of lung cancer with sleep duration was more particularly pronounced among women who worked at night ≥5 years. Our findings suggested that sleep patterns are associated with lung cancer risk in women with a potential modifying effect by night shift work duration or tobacco smoking.

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Obstructive Sleep Apnea and Lung Cancer: A Systematic Review and Meta-Analysis

Cited by 34 publications

References 35 publications

Obstructive sleep apnea and the incidence and mortality of gastrointestinal cancers: a systematic review and meta-analysis of 5,120,837 participants

Obstructive sleep apnea and the incidence and mortality of gastrointestinal cancers: a systematic review and meta-analysis of 5,120,837 participants

Manuscript Title: A 4-miRNAs Serum Panel for Obstructive Sleep Apnea Syndrome Screening

Sleep Traits, Night Shift Work and Lung Cancer Risk among Women: Results from a Population-Based Case-Control Study in France (The WELCA Study)

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