Abstract
Background Increasing evidence suggests that obstructive sleep apnoea (OSA) contributes to cancer risk; however, limited data are available on the impact of continuous positive airway pressure (CPAP) therapy on cancer incidence. We aimed to determine whether adherence to CPAP therapy is associated with a reduction in all-cancer incidence compared with nonadherent patients with OSA.
Methods The study relied on data collected by the multicentre Pays de la Loire Sleep Cohort study, linked to health administrative data, so as to identify new-onset cancer. We included patients who were prescribed CPAP for OSA, with no history of cancer before the diagnostic sleep study or during the first year of CPAP. Patients with documented CPAP use for ≥4 h per night were defined as adherent. Those who discontinued or used CPAP <4 h per night constituted the nonadherent group. A propensity score inverse probability of treatment weighting analysis was performed to assess the effect of CPAP adherence on cancer risk.
Results After a median (interquartile range) follow-up of 5.4 (3.1–8.0) years, 437 (9.7%) out of 4499 patients developed cancer: 194 (10.7%) in the nonadherent group (n=1817) and 243 (9.1%) in adherent patients (n=2682). The final weighted model showed no significant impact of CPAP adherence on all-cause cancer risk (subdistribution hazard ratio 0.94, 95% CI 0.78–1.14).
Conclusions Adherence to CPAP therapy in OSA patients was not associated with a reduction in all-cancer incidence. Whether adherent CPAP therapy of OSA might reduce the risk of specific cancer sites should be further evaluated.
Abstract
In a multicentre-based cohort of patients with mild-to-severe obstructive sleep apnoea, sustained and adherent CPAP therapy was not associated with a reduction in all-cancer incidence after a median follow-up time of 5.4 years https://bit.ly/3mdiOxI
Footnotes
This article has an editorial commentary: https://doi.org/10.1183/13993003.02742-2021
Conflict of interest: G. Justeau has nothing to disclose.
Conflict of interest: S. Bailly reports consulting fees for methodology and statistical analyses from Institut Recherche en Santé Respiratoire des Pays de la Loire, outside the submitted work.
Conflict of interest: C. Gervès-Pinquié has nothing to disclose.
Conflict of interest: W. Trzepizur has nothing to disclose.
Conflict of interest: N. Meslier has nothing to disclose.
Conflict of interest: F. Goupil has nothing to disclose.
Conflict of interest: T. Pigeanne has nothing to disclose.
Conflict of interest: S. Launois has nothing to disclose.
Conflict of interest: L. Leclair-Visonneau has nothing to disclose.
Conflict of interest: P. Masson has nothing to disclose.
Conflict of interest: A. Bizieux-Thaminy has nothing to disclose.
Conflict of interest: J-L. Racineux has nothing to disclose.
Conflict of interest: D. Gozal reports NIH grants, outside the submitted work.
Conflict of interest: F. Gagnadoux reports support for the present manuscript from Institut Recherche en Santé Respiratoire des Pays de la Loire to the University Hospital of Angers; consulting fees from Nyxoah, Sefam and ResMed; payment or honoraria for lectures from Cidelec, Asten Santé and Boehringer Ingelheim; payment for expert testimony from Boehringer Ingelheim; support for attending meetings and/or travel from Asten Santé and Actelion; participation on a data safety monitoring board or advisory board for Jazz Pharmaceutical; receipt of equipment, materials, drugs, medical writing, gifts or other services from Inspire to the University Hospital of Angers, outside the present work.
Support statement: This study was supported by a grant from the Institut de Recherche en Santé Respiratoire des Pays de la Loire (IRSR), Beaucouzé, France. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received July 10, 2021.
- Accepted August 10, 2021.
- Copyright ©The authors 2022. For reproduction rights and permissions contact permissions{at}ersnet.org
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