阻塞性睡眠呼吸暂停与泌尿系统癌症发病率和死亡率的关系--系统回顾与元分析》（The Association of Obstructive Sleep Apnea with Urological Cancer Incidence and Mortality-A Systematic Review and Meta-analysis）。
Brian Sheng Yep Yeo, Dominic Wei Ting Yap, Nicole Kye Wen Tan, Benjamin Kye Jyn Tan, Yao Hao Teo, Yao Neng Teo, Alvin Lee, Anna See, Henry Sun Sien Ho, Jeremy Yuen-Chun Teoh, Kenneth Chen, Song Tar Toh
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This study aims to summarize and synthesize evidence to clarify the association between OSA and urological cancer incidence and mortality.</p><p><strong>Methods: </strong>According to a prespecified protocol, PubMed, Embase, Cochrane Library, and Scopus were searched from inception to November 16, 2023, for observational and randomized studies reporting the association of OSA with urological cancer incidence or mortality. We pooled maximally covariate-adjusted hazard ratios (HRs) using a random-effects inverse variance-weighted model. Two reviewers independently assessed the quality of evidence using the Newcastle-Ottawa Scale and the Grading of Recommendations, Assessment, Development and Evaluation framework.</p><p><strong>Key findings and limitations: </strong>From 1814 records, we included 12 studies comprising 9 290 818 participants in total, of which nine studies were analyzed quantitatively. 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引用次数: 0
摘要
背景和目的：虽然阻塞性睡眠呼吸暂停（OSA）和泌尿系统癌症都与缺氧密切相关，但它们之间的关系却存在争议。本研究旨在总结和归纳证据，以澄清 OSA 与泌尿系统癌症发病率和死亡率之间的关系：根据预先确定的方案，我们检索了 PubMed、Embase、Cochrane Library 和 Scopus 上从开始到 2023 年 11 月 16 日报道 OSA 与泌尿系统癌症发病率或死亡率相关性的观察性和随机研究。我们采用随机效应反方差加权模型对最大协变量调整后的危险比（HRs）进行了汇总。两位评审员使用纽卡斯尔-渥太华量表和建议、评估、发展和评价分级框架独立评估了证据的质量：从 1814 份记录中，我们纳入了 12 项研究，共有 9 290 818 人参与，其中 9 项研究进行了定量分析。OSA患者罹患肾癌（HR：1.75，95% 置信区间[CI]：1.21-2.53）和膀胱癌（HR：1.76，95% 置信区间[CI]：1.05-2.96）的风险增加。但 OSA 与前列腺癌的发病率无关（HR：1.29，95% CI：0.82-2.04）。我们系统地回顾了有关 OSA 与睾丸癌发病率和泌尿系统癌症死亡率的证据：OSA可能与较高的肾癌和膀胱癌风险有关，但与前列腺癌无关。未来的工作可能有助于澄清 OSA 与泌尿系统癌症之间可能存在的剂量反应关系，以及 OSA 治疗对泌尿系统癌症发病率或进展的影响。患者总结：这项研究强调了 OSA 与肾癌和膀胱癌之间的潜在纵向联系，但与前列腺癌无关。
The Association of Obstructive Sleep Apnea with Urological Cancer Incidence and Mortality-A Systematic Review and Meta-analysis.
Background and objective: While obstructive sleep apnea (OSA) and urological cancer are both strongly associated with hypoxia, controversy exists regarding their association with each other. This study aims to summarize and synthesize evidence to clarify the association between OSA and urological cancer incidence and mortality.
Methods: According to a prespecified protocol, PubMed, Embase, Cochrane Library, and Scopus were searched from inception to November 16, 2023, for observational and randomized studies reporting the association of OSA with urological cancer incidence or mortality. We pooled maximally covariate-adjusted hazard ratios (HRs) using a random-effects inverse variance-weighted model. Two reviewers independently assessed the quality of evidence using the Newcastle-Ottawa Scale and the Grading of Recommendations, Assessment, Development and Evaluation framework.
Key findings and limitations: From 1814 records, we included 12 studies comprising 9 290 818 participants in total, of which nine studies were analyzed quantitatively. OSA patients had an increased risk of kidney (HR: 1.75, 95% confidence interval [CI]: 1.21-2.53) and bladder (HR: 1.76, 95% CI: 1.05-2.96) cancer. However, OSA was not associated with prostate cancer incidence (HR: 1.29, 95% CI: 0.82-2.04). We systematically reviewed evidence surrounding OSA and testicular cancer incidence and urological cancer mortality.
Conclusions and clinical implications: OSA may be associated with a higher risk of kidney and bladder cancer, but not prostate cancer. Future work may help clarify the possibility of a dose-response relationship between OSA and urological cancer, and the effect of OSA treatment on urological cancer incidence or progression.
Patient summary: This research highlights a potential longitudinal association between OSA and kidney and bladder cancer, but not prostate cancer.
期刊介绍：
European Urology Focus is a new sister journal to European Urology and an official publication of the European Association of Urology (EAU).
EU Focus will publish original articles, opinion piece editorials and topical reviews on a wide range of urological issues such as oncology, functional urology, reconstructive urology, laparoscopy, robotic surgery, endourology, female urology, andrology, paediatric urology and sexual medicine. The editorial team welcome basic and translational research articles in the field of urological diseases. Authors may be solicited by the Editor directly. All submitted manuscripts will be peer-reviewed by a panel of experts before being considered for publication.
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