Obstructive Sleep Apnea and Cancer Burden: Impact of Apnea Severity and Treatment

阻塞性睡眠呼吸暂停和癌症负担：呼吸暂停严重程度和治疗的影响

基本信息

批准号：
9305919
负责人：
AMANDA IRENE PHIPPS
金额：
$ 7.75万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-08-01 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9305919
关键词：
Address Adult Affect Apnea Apoptosis Area Biological Body mass index Cancer Burden Cancer Survivorship Cardiovascular Diseases Catchment Area Cell Culture Techniques Cessation of life Characteristics Chronic Clinical Clinical Management Cohort Studies Communities Comorbidity Computerized Medical Record Continuous Positive Airway Pressure County Demographic Factors Diabetes Mellitus Diagnosis Diagnostic Disease Epidemic Evaluation Exposure to Foundations Health Heart Diseases High Prevalence Hour Hypertension Hypoxia In Vitro Incidence Individual Intervention Investigation Knowledge Left Light Link Literature Longitudinal Studies Malignant Neoplasms Measurement Measures Medical Records Medicine Modeling Morbidity - disease rate Newly Diagnosed Obesity Obstruction Obstructive Sleep Apnea Occupational Occupational injury Oxygen Patients Physiological Population Prevalence Primary Prevention Public Health Radiation Records Recurrence Registries Research Resistance Risk SEER Program Secondary Prevention Severities Site Sleep Sleep Apnea Syndromes Smoking History Stroke Suggestion Survival Rate Time Translating United States Universities University resources Visit Washington Work base burden of illness cancer cell cancer diagnosis cancer prevention cancer risk cancer survival compliance behavior diagnostic biomarker electronic data epidemiology study follow-up improved indexing insight mortality motor vehicle injury mouse model neoplasm registry novel patient population population based prognostic public health intervention screening tertiary prevention tumor tumor growth

项目摘要

PROJECT SUMMARY / ABSTRACT Obstructive sleep apnea (OSA) affects approximately 18 to 22 million adults in the United States. As the prevalence of OSA continues to increase with the growing obesity epidemic, so too has our understanding of the far-reaching health consequences of OSA, including an increased risk of hypertension, heart disease, stroke, diabetes, occupational injuries, motor vehicle injuries, and overall mortality. Recently, evidence suggestive of yet another important disease burden associated with OSA has begun to emerge: increased risk of incident cancer and cancer mortality. Given that OSA is a highly treatable condition, such evidence suggests an important opportunity for cancer prevention. Few epidemiologic studies, however, have explored the possible link between OSA and cancer, and no studies, to date, have assessed the impact of OSA treatment on cancer rates. The objective of this project is to evaluate the relationship of obstructive sleep apnea with cancer incidence and survival, placing particular focus on the impact of obstructive sleep apnea severity and treatment on cancer rates. In Aim 1, we will characterize ways in which the severity of OSA, captured in the form of five clinical measurements recorded during diagnostic sleep studies, relates to cancer incidence (1a) and to cancer survival and prognostic tumor characteristics (1b). In Aim 2, we will examine the association of continuous positive airway pressure (CPAP) treatment use for OSA, and CPAP treatment compliance, with cancer incidence (2a) and cancer survival (2b). In pursuit of these Aims, this project efficiently leverages an ongoing linkage between medical records from the University of Washington (UW) Sleep Center and the Surveillance, Epidemiology, and End Results (SEER) cancer registry serving western Washington State. Building on this linkage, detailed medical record review will be conducted on a subset of the >15,000 patients diagnosed with OSA at the UW Sleep Center between 2005-2011, including all such patients diagnosed with cancer after being diagnosed with OSA (N~920) and a subset of OSA patients not diagnosed with cancer (N~720). Through this detailed medical record review and by extracting data from electronic medical records, information will be collected on demographic factors, comorbidities, body mass index, and smoking history, as well as measures of OSA severity collected at the time of OSA diagnosis, and indicators of CPAP use and compliance collected at UW Sleep Center follow-up visits. Information on cancer attributes from the SEER registry, such as tumor site and stage at cancer diagnosis, will facilitate further detailed analyses. This study will mark one of the largest, and the most comprehensive investigation into the relationship between OSA and cancer to date. Informed interventions to improve the diagnosis of OSA and encourage proper OSA treatment could provide an efficient approach to reducing cancer incidence and improving cancer survival. Insights gained through this novel study could thus motivate important opportunities for primary, secondary, and tertiary prevention of cancer morbidity and death through OSA screening and treatment.

项目概要/摘要阻塞性睡眠呼吸暂停 (OSA) 影响着美国大约 18 至 2200 万成年人。作为随着肥胖流行病的日益严重，OSA 的患病率持续增加，我们对 OSA 对健康造成深远影响，包括增加患高血压、心脏病、中风、糖尿病、职业伤害、机动车伤害和总体死亡率。近日，证据表明与 OSA 相关的另一种重要疾病负担已经开始出现：风险增加癌症发生率和癌症死亡率。鉴于 OSA 是一种高度可治疗的疾病，这些证据表明预防癌症的重要机遇。然而，很少有流行病学研究探讨了 OSA 与癌症之间可能存在联系，迄今为止还没有研究评估 OSA 治疗的影响关于癌症发生率。该项目的目的是评估阻塞性睡眠呼吸暂停与癌症发病率和生存率，特别关注阻塞性睡眠呼吸暂停严重程度和生存率的影响癌症发生率的治疗。在目标 1 中，我们将描述 OSA 严重程度的特征，并在在诊断性睡眠研究期间记录的五种临床测量形式，与癌症发病率相关 (1a) 以及癌症生存和预后肿瘤特征 (1b)。在目标 2 中，我们将检查以下关联：持续气道正压通气 (CPAP) 治疗 OSA 的使用以及 CPAP 治疗依从性癌症发病率 (2a) 和癌症生存率 (2b)。为了实现这些目标，该项目有效地利用了华盛顿大学 (UW) 睡眠中心的医疗记录与为华盛顿州西部提供服务的监测、流行病学和最终结果 (SEER) 癌症登记处。在此联系的基础上，将对超过 15,000 名患者中的一部分进行详细的病历审查 2005 年至 2011 年间在威斯康辛大学睡眠中心被诊断患有 OSA 的患者，包括所有被诊断患有 OSA 的患者诊断患有 OSA 后罹患癌症 (N~920) 以及一部分未诊断出患有癌症的 OSA 患者（N~720）。通过详细的病历审查并从电子病历中提取数据，将收集有关人口因素、合并症、体重指数和吸烟史的信息，例如以及在 OSA 诊断时收集的 OSA 严重程度测量值，以及 CPAP 使用指标和在华盛顿大学睡眠中心随访中收集的依从性。来自 SEER 的癌症属性信息登记处，例如癌症诊断的肿瘤部位和分期，将有助于进一步的详细分析。这项研究这将是对 OSA 和迄今为止的癌症。采取知情干预措施以改善 OSA 的诊断并鼓励正确的 OSA 治疗可以提供一种有效的方法来降低癌症发病率和提高癌症生存率。见解因此，通过这项新颖的研究获得的成果可以为小学、中学和大学提供重要的机会。通过 OSA 筛查和治疗预防癌症发病和死亡。