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Cancer diagnosis risk for women with sleep apnoea

Tuesday May 21st, 2019

Women with obstructive sleep apnoea are more likely to be diagnosed with cancer than men with the condition, according to Greek research published last night.

Investigators at Aristotle University also found that people who experience more closures of the airways during sleep and whose blood oxygen saturation levels drop below 90% more frequently are more likely to be diagnosed with cancer than people without OSA.

The study, led by Athanasia Pataka, assistant professor of respiratory medicine at Aristotle University, is published in the latest edition of the European Respiratory Journal.

It involved analysis of data from 19,556 people included in the European Sleep Apnoea Database (ESADA), of whom 5,789 were women and 13,767 men. All were assessed for their age, BMI, smoking status and level of alcohol use, as these factors can impact the risk of developing cancer.

The research team examined the number of times the participants experienced partial or complete airways closure per hour of sleep, and how many times during the night their blood oxygen levels dropped below 90%.

They found that 388 people (2%) had been diagnosed with a serious cancer - 160 women and 228 men. This equated to 2.8% of all women and 1.7% of all men in the ESADA group.

Those who were diagnosed with cancer were likely to be over 50 years and less overweight, and the most common type of cancer among women was breast cancer, while prostate cancer was the most prevalent among men.

When the researchers analysed the data again according to the participants' sex, they found that the odds of cancer diagnosis were higher in women with severe OSA and who had more severely lowered blood oxygen levels during sleep compared with women without OSA.

However, this trend was not the same when comparing men with OSA compared with men without OSA.

Professor Pataka said: "Our study of more than 19,000 people shows that severity of OSA is linked to a cancer diagnosis. This link was especially strong in the women that we analysed, and less so in the men, and suggests that severe OSA could be an indicator for cancer in women, though more research is needed to confirm these findings.

"Our study did not explicitly explore the causes of different cancers, but cancer may differ between men and women because of factors such as how hormones affect tumour growth; how the different types of cancer that were more prevalent in men and women are affected by low blood oxygen levels; or how gender specific exposure to cigarette smoking may play a role."

Professor Anita Simonds, consultant in respiratory and sleep medicine at Royal Brompton and Harefield NHS Foundation Trust and vice president of the European Respiratory Society, said the study added to the growing evidence of the possible link between the effects of OSA such as low blood oxygen levels and the risk of developing cancer. It also provided new data on potential gender differences.

The research team hopes to undertake a follow-up study to evaluate the number of cancer diagnoses and cancer deaths in the ESADA population with OSA.

Pataka A, Bonsignore MR, Ryan S, et al. Cancer prevalence is increased in females with sleep apnoea – data from the ESADA. Eur Respir J 20 May 2019.

https://doi.org/10.1183/13993003.00091-2019

Tags: Cancer | Europe | Respiratory | Women's Health & Gynaecology

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