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Risk of cancer in patients with sleep apnea: comparison of surgery versus CPAP in a long-term follow-up study

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Abstract

Purpose

This study aimed to obtain a comprehensive view of the risk of developing cancer in patients with obstructive sleep apnea (OSA) and to compare this risk between patients receiving continuous positive airway pressure (CPAP) therapy versus upper airway surgery (UAS).

Methods

We used both local data and a global-scale federated data research network, TriNetX, to access electronic medical records, including those of patients diagnosed with OSA from health-care organizations (HCOs) worldwide. We used propensity score matching and the score-matched analyses of data for 5 years of follow-up,

Results

We found that patients who had undergone UAS had a similar risk of developing cancer than those who used CPAP [hazard ratio of 0.767 (95% CI 0.559–1.053; P = 0.100)].

Conclusion

Analysis of the large data sets collected from HCOs in Europe and globally lead us to conclude that in patients with OSA, neither CPAP nor UAS were associated with the development of cancer better than in non-treated patients.

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Availability of data and materials

The data that support the findings of this study are available from TriNetX but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of TriNetX.

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Acknowledgements

This project was supported in part by TriNetX

Funding

This research received no external funding.

Author information

Authors and Affiliations

  1. Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29680, Marbella, Spain

    Carlos O’Connor-Reina, Laura Rodriguez Alcala & Juan Carlos Casado Morente

  2. Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, Palmones, Spain

    Carlos O’Connor-Reina & Laura Rodriguez Alcala

  3. Neumology Department, Hospital Quironsalud Marbella, Marbella, Spain

    Jose Maria Ignacio

  4. Otorhinolaryngology Department, Hospital Universitario Virgen de Valme, Seville, Spain

    María Teresa Garcia-Iriarte

  5. Otorhinolaryngology Department Hospital Universitario Dr Peset, Valencia, Spain

    Marina Carrasco Llatas

  6. Biomedical Informatics Group, Universidad Politécnica de Madrid, Madrid, Spain

    David Perez del Rey & Alba Segovia Hilara

  7. TriNetX Europe NV, Sint-Martens-Latem, Belgium

    Gema Hernandez Ibarburu

  8. Otorhinolaryngology Department, Clínica Universitaria de Navarra, Pamplona, Spain

    Peter Baptista

  9. Otorhinolaryngology Department, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, Spain

    Guillermo Plaza

  10. Otorhinolaryngology Department, Hospital Universitario Sanitas La Zarzuela, Madrid, Spain

    Guillermo Plaza

Authors
  1. Carlos O’Connor-Reina
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  2. Laura Rodriguez Alcala
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  3. Jose Maria Ignacio
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  9. Gema Hernandez Ibarburu
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  11. Guillermo Plaza
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Contributions

Conceptualization, COR and LRA; methodology, JMI and MTGI; software, DPR; validation, IMA, DPR, and GHI; formal analysis, MCLL; investigation, COR and MGI; resources, PB; data curation, GP; writing—original draft preparation, GP; writing—review and editing, COR; visualization, PB; supervision, GP and JCM. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Carlos O’Connor-Reina.

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Conflict of interest

No competing interests.

Ethics approval and consent to participate

As TriNetX is a federated network, research studies using it do not require ethical approval. To comply with legal frameworks and ethical guidelines guarding against data re-identification, the identity of participating HCOs and their individual contribution to each dataset are not disclosed. The TriNetX platform only uses aggregated counts and statistical summaries of de-identified information. No protected health information or personal data are made available to the users of the platform.

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This article is part of the Topical Collection on sleep apnea syndrome. Guest editors: Manuele Casale, Rinaldi Vittorio.

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O’Connor-Reina, C., Rodriguez Alcala, L., Ignacio, J.M. et al. Risk of cancer in patients with sleep apnea: comparison of surgery versus CPAP in a long-term follow-up study. Eur Arch Otorhinolaryngol 281, 3131–3141 (2024). https://doi.org/10.1007/s00405-023-08446-3

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