Cancer in the Long-Term Care of Patients with Obstructive Sleep Apnea: a closer look

<bold>Objectives:</bold> Recent findings in Obstructive Sleep Apnea (OSA) suggest a potential link to increased cancer risk. <bold>Methods:</bold>Retrospective study on OSA patients that developed cancer over follow-up, during a 10-year period. Statistical analysis included T-student and chi-square tests for variable comparisons. Survival was assessed using Kaplan-Meier curves and log-rank test. <bold>Results:</bold> In a cohort of 415 patients, 229 had OSA before cancer. 73.4% were male, with a mean age of aged 67±9.7 years at cancer diagnosis. Most (86%) were overweight, with 20% being smokers. About half (51.5%) the patients presented excessive daytime sleepiness, assessed by the Epworth Sleepiness Scale (ESS). One-hundred and six (46.3%) patients presented severe OSA. Mean nightly peripheral oxygen saturation (SpO2) was 91.3±3.5% with roughly a third of patients having nocturnal hypoxia (NH) (33.6%). Most patients (n=177) were proposed to Positive Airway Pressure (PAP) therapy. The mean time until cancer diagnosis was 57.4±51.2 months. The most prevalent primary malignancies were lung (40.6%), colorectal (14.4%) and breast (8.7%). Only 28.8% of patients had disseminated disease at the time of diagnosis. While no differences in disease progression were found when considering a therapeutic adherence threshold of ≥4 hours, those adhering ≥6 hours showed a significantly reduced progression risk (p=0.009). Lung cancer patients, with NH presented higher rates of advanced disease at diagnosis (p=0.004) and significatively worse median overall survival (OS) (p=0,014). <bold>Conclusions:</bold> Adherence to OSA treatment may impact the severity of oncologic disease. In lung cancer, NH was related to advanced neoplasm at time of diagnosis as well as worse OS.