Do sleep apnea patients have an increased risk of cancer and does CPAP treatment decrease this risk?

Tidsperiod:

1 januari 2020 – 31 december 2021

Projektledare:

Jenny Theorell-Haglöw

Projektdeltagare:

Magnus Ekström, Mirjam Ljunggren, Andreas Palm, Ludger Grote

Finansiär:

Hjärt-Lungfonden

Bidragstyp:

Projektbidrag

Budget:

600 000 SEK

Bakgrund:

Obstructive sleep apnea (OSA) is a highly prevalent sleep-related breathing disorder resulting in important negative effects such as daytime sleepiness, diabetes and hypertension. Previous research point toward a relationship between OSA and cancer and there is a pressing public health and clinical need to study the relationship further. However, previous clinic-based studies have evident weaknesses such as the inclusion of highly selected populations (i.e., those referred for sleep studies) and therefore population-based studies present an advantage. Nonetheless, longitudinal population-based cohorts where OSA is properly phenotyped and then linked to cancer outcomes are extremely rare, because of the considerable cost of performing overnight sleep studies. Furthermore, very few large-scale OSA treated patient cohorts have data on cancer development.

Målsättning:

The aim is to investigate whether previously seen increased risk of cancer in OSA in selected cohorts is also true in large population-based samples and to assess if OSA treatment with CPAP decreases the risk of cancer.

The research questions are:

1. Does sleep apnea increase the risk of cancer and if so, what types of cancer does sleep apnea increases the risk for?

2. If sleep apnea increases risk of cancer, is this related hypoxia or number of apnea and/or hypopnea events?

3. Are relationships found, affected by age, sex, concurrent obesity, or lifestyle factors?

4. Does treatment with CPAP influence the risk of cancer in patients with sleep apnea?

Arbetsplan:

In step 1 we plan to pool 5 population-based cohorts (n=2,285) with objectively measured OSA data and also cancer data to generate a large longitudinal population-based cohort and be able to study population-based cancer risk in OSA. As Step 2 we propose to use patient register cross-linkage data from Swedevox quality register and the Swedish Cancer register to assess if OSA patients treated with CPAP (n=21,339) have decrease risk of cancer development compared with non-treated OSA patients.

Betydelse:

This study has the potential to give further clarification as to what types of cancer OSA increases the risk for, and if there are any subgroups that are most at risk. It may also clarify whether treatment of OSA with CPAP decreases the risk of cancer. Together this is directly beneficial from a public health as well as a medical perspective when diagnosing and treating people with OSA as well as cancer.