Unmasking the link between sleep apnea and lung cancer risk: A retrospective propensity-matched cohort study.

Abstract

10558 Background: Obstructive sleep apnea (OSA) is a prevalent disorder characterized by intermittent hypoxia, systemic inflammation, hypercapnia, and oxidative stress. These factors pose a risk for carcinogenesis and potential tumor formation. The association between OSA and lung cancer remains unclear. This study evaluates the impact of OSA on lung cancer incidence using a large-scale retrospective cohort analysis. Methods: A comparative outcomes analysis was conducted using the TriNetX database. Data were extracted from the Johns Hopkins Medicine healthcare organization. Two cohorts were defined: patients with OSA (Cohort 1, n = 124,100) and those without OSA (Cohort 2, n = 2,330,110). Propensity score matching (PSM) was employed to balance baseline characteristics, including age, gender, race, and comorbid conditions, resulting in 62,750 in each cohort. The primary outcome was lung cancer incidence (ICD-10: C34), with risk difference (RD), risk ratio (RR), and odds ratio (OR) calculated to compare the cohorts. Statistical significance was set at p < 0.05. Results: Before propensity score matching, the OSA cohort had a higher mean age (60.8 ± 16.6 vs. 51.8 ± 20.3 years) and a higher prevalence of comorbid conditions such as obesity, hypertension, and diabetes compared to the non-OSA cohort (all p < 0.001). After PSM, demographic and clinical characteristics were well-balanced between cohorts. In the matched analysis, the incidence of lung cancer was slightly higher in the OSA cohort at 0.8% (n = 530) compared to 0.7% (n = 440) in the non-OSA cohort. The RD was 0.1% (95% CI: 0.0%-0.2%, p = 0.004 via T-Test), and the RR was 1.205 (95% CI: 1.062-1.366). The OR for lung cancer in OSA patients relative to non-OSA patients was 1.206 (95% CI: 1.063-1.369). Kaplan-Meier survival analysis showed a modestly reduced time to lung cancer diagnosis in the OSA cohort, although the difference was not clinically significant. Conclusions: This study reveals a statistically significant association between OSA and lung cancer risk. Subsequent studies are needed to investigate the degree of clinical significance between OSA and lung cancer. OSA patients may benefit from screening and/or early intervention strategies. Additionally, further research is needed to elucidate the potential mechanism and pathogenesis of lung cancer formation in OSA patients. Lung cancer incidence and associated risk estimates in patients with and without OSA. Cohort Lung cancer incidence RD RR OR OSA (n=62,750) 0.8% (n=530) 0.1% (95% CI: 0.0%-0.2%, p = 0.004 1.205 (95% CI: 1.062-1.366) 1.206 (95% CI: 1.063-1.369) Non-OSA (n=62,750) 0.7% (n=440)