Table 1.
Summary of the epidemiology of OSA and lung cancer.
| Author, year | Design | Sample sizes | Age (years) |
Male (%) | Types of lung cancer | OSA diagnosis | Follow-up duration (years) | Adjustments | Main findings | References |
|---|---|---|---|---|---|---|---|---|---|---|
| OSA in patients with lung cancer | ||||||||||
| Cabezas, 2018 | NR | 60 | 67.8 | 58 | NSCLC (83.3%) SCLC (16.7%) | HSAT | NR | NA | 48/60, 18 (30%) with mild, 30 (50%) with moderate-to-severe SDB | (7) |
| Liu, 2022 |
Retrospective clinical cohort | 410 | 59.98 | 58 | NSCLC (82.2%) SCLC (17.8%) | Portable sleep recorder | NR | NA | 128/410 | (21) |
| Lee, 2022 |
NR | 69 | 68 | 73 | NSCLC (88.4%) SCLC (11.6%) | HSAT | NR | NA | 39/69, 21 (30%) with mild, 10 (15%) with moderate, and 8 (12%) with severe SDB | (20) |
| Bhaisare, 2022 | Prospective clinical study | 30 | 55 | 87 | NSCLC (97%) SCLC (3%) | PSG | NR | NA | 17/30, mild, moderate, and severe OSA were seen in 26.6%, 16.6%, and 13.3% | (19) |
| Lung cancer in patients with OSA: incidence or prevalence | ||||||||||
| Gozal, 2016 | Retrospective matched cohort | 3408906 | 50–59, range | 50.2 | NR | ICD-9-CM | 1.87–3.91, range | Age, sex, morbid obesity, hypertension, type 2 diabetes, ischemic heart disease, coronary heart failure, stroke, cardiac arrhythmias, and depression | HR: 1.09, CI: 1.05–1.13; HR: 1.02, CI: 0.99–1.13 (After adjustment) |
(25) |
| Jara, 2020 | Retrospective matched cohort | 1377285 | 55.2 | 94 | NR | ICD-9 | 7.4 | Age, sex, year of cohort entry, race, smoking status, alcohol use, obesity, and comorbidity | HR: 1.32, CI: 1.27–1.38 | (26) |
| Huang, 2021 | Prospective cohort | 65330 | 73.3 | 0 | NR | Self-reported. 108 people were sampled for PSG, OSA=98% | 8 | Age, ethnicity, family history of cancer, BMI, height, pack-years of smoking, alcohol drinking, physical activity, sleep duration, duration of hormonal therapy use by type, history of type 2 diabetes, aspirin use, and recent physical examination | HR: 1.52, CI: 1.07–2.17; HR: 2.96, CI: 1.42–6.18 (in never-smoked OSA patients) |
(27) |
| Kendzerska, 2021 | Retrospective cohort | 33997 | 50 | 58 | NR | PSG | 7 | Sleep clinic site, age, sex, alcohol use disorder, prior CHF, COPD, hypertension, diabetes, and OSA treatment | Severe OSA vs. Non-OSA: HR: 1.38, CI: 0.94–2.04; Q4 (AHI ≥28) vs. Q1 (AHI <4): HR: 1.78, CI: 1.03–3.10; Mean SaO2: Q4 (SaO2 ≥96%) vs. Q1 (SaO2 <93.4%): HR: 2.05, CI: 1.01–4.15 |
(28) |
| Justeau, 2020 | Retrospective cohort | 8748 | 61 | 64.50 | NR | PSG | 5.8 | Age, sex, BMI, smoking status, alcohol intake, diabetes, hypertension, medical history of cardiac disease and COPD, and marital status | T90% (percent nighttime with oxygen saturation <90%) ≥13 vs. T90% <0.01, HR: 2.14, CI: 1.01–4.54 | (23) |
| Brenner, 2018 | Retrospective cohort | 5243 | 51 | 74.50 | NR | PSG | 5.9 | Age, sex, and BMI | OSA does not increase the incidence of lung cancer | (32) |
| Marriott, 2023 | Retrospective cohort | 20289 | NR | 68.70 | NR | PSG | 11.2 | Age, BMI, sex, and smoking status | HR: 0.80, CI: 0.51–1.26; T90% ≥2.2 vs. T90% <0.1, HR: 0.96, CI: 0.67–1.38 |
(24) |
| Sillah, 2018 | Retrospective cohort | 34402 | 51.6 | 54.70 | NR | ICD | 5.3 | Age and sex | Age–sex standardized cancer incidence ratios (SIR): 0.66, CI: 0.54–0.79 | (34) |
| Park, 2023 | Retrospective cohort | 1607094 | 45.7 | 75.80 | NR | ICD-10 | 5.9 | Sex, age, subjects’ income levels, diabetes, hypertension, dyslipidemia, stroke, chronic obstructive pulmonary disease, and ischemic heart disease | HR: 0.87, CI: 0.82–0.93; Male OSA, HR: 0.84, CI: 0.78–0.90; Female OSA, HR: 1.05, CI: 0.91–1.21; |
(33) |
| Seijo, 2019 | Cross-sectional study | 302 | 64.7 | 58.60 | NR | HSAT | NR | Age, sex, smoking, alcohol consumption, emphysema, BMI, neck circumference, basal oxygen saturation by pulse oximetry and sedative consumption | AHI (ln), OR: 1.382, CI: 1.015–1.882; ODI 3% (ln), OR: 1.452, CI: 1.056–1.997; |
(30) |
| Xiong, 2022 | Retrospective cohort | 4623 | 62.6 | 80.70 | PSG | PSG | 9.1 | Sex, age, BMI, smoking status, hypertension, CHD, type 2 diabetes, and hyperuricemia | OSA does not increase the prevalence of lung cancer | (31) |
| Lung cancer in patients with OSA: prognosis | ||||||||||
| Liu, 2020 | NR | 44 | NSCLC:63.55; OSA+ NSCLC:58.45 | 63.60 | NSCLC | PSG | 1.8 | TNM stage III-IV; Refusal of treatment; Pretreatment TGF-β1 level | Pretreatment VEGF (level >950 pg/ml), HR: 1.003, CI: 1.001–1.005 (multivariate); OSA, HR: 1.06, CI: 0.36–3.16 (univariate); |
(44) |
| Liu, 2019 | NR | 45 | NR | NR | NR | Portable sleep recorder | 1 | NR | The overall rate of deterioration (death + recurrence or metastasis) was significantly higher in the OSA group than in the non-OSA subgroup (P<0.05) | (42) |
| Huang, 2020 | Retrospective | 16 | 62.4 | 94% | III and IV lung cancer | PSG | 5 | AHI, T90%, and Eastern Cooperative Oncology Group status | Kaplan–Meier survival analysis, patients with stage III–IV lung cancer and AHI <30 events/h exhibited significantly better overall survival (P=0.02) and progression-free survival (P=0.02) than patients with severe OSA |
(8) |
AHI, apnea-hypopnea index; BMI, body mass index; CHD, coronary heart disease; CHF, chronic heart failure; COPD, chronic obstructive pulmonary disease; HSAT, home sleep apnea test; ICD, International Classification of Diseases; NA, not available; NR, not reported; NSCLC, non-small cell lung cancer; PSG, full polysomnography; SCLC, small cell lung cancer; SDB, sleep-disordered breathing; T90%, percent night time with oxygen saturation <90%; TGF, transforming growth factor.