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 to non-adherent patients with OSA.
Methods The study relied on the data collected by the multicentre study Pays de la Loire Sleep Cohort, linked to health administrative data, such 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 at least 4 h per night were defined as adherent. Those who discontinued or used CPAP less than 4 h at night constituted the non-adherent 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 [inter-quartile range] follow-up of 5.4 [3.1–8.0] years, 437 (9.7%) of 4,499 patients developed cancer, 194 (10.7%) in the non-adherent 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 (sub distribution hazard ratio [95% confidence interval]): 0.94 [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.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Grégoire Justeau has nothing to disclose.
Conflict of interest: S. Bailly reports Consulting fees for methodology and statistical analyses from ISRS Pays de la Loire, outside the submitted work.
Conflict of interest: Chloé Gervès-Pinquié has nothing to disclose.
Conflict of interest: Wojciech Trzepizur has nothing to disclose.
Conflict of interest: Nicole Meslier has nothing to disclose.
Conflict of interest: François Goupil has nothing to disclose.
Conflict of interest: Thierry Pigeanne has nothing to disclose.
Conflict of interest: Sandrine Launois has nothing to disclose.
Conflict of interest: Laurene Leclair-Visonneau has nothing to disclose.
Conflict of interest: Philippe Masson has nothing to disclose.
Conflict of interest: Acya Bizieux-Thaminy has nothing to disclose.
Conflict of interest: Jean-Louis Racineux has nothing to disclose.
Conflict of interest: D. Gozal reports NIH grants outside the submitted work. All other authors have nothing to disclose.
Conflict of interest: F. Gagnadoux reports support for the present manuscript from Institut Recherche en Santé Respiratoire des Pays de la Loire to University Hospital of Angers; consulting fees from NYXOAH, SEFAM and RESMED; payment or honoraria for lectures from CIDELEC, ASTEN SANTE and BOEHRINGER INGELHEIM; payment for expert testimony from BOEHRINGER INGELHEIM; support for attending meetings and/or travel from ASTEN SANTE 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 University Hospital of Angers, outside the present work.
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- Received July 10, 2021.
- Accepted August 10, 2021.
- Copyright ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org
