Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2026
Association of obstructive sleep apnea with pancreatic cancer in high-risk patients under surveillance in CAPS and PCYST cohorts.
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Sinan Hassan, Sleiman Emy Abou, Blackford Amanda L, Shinozuka Takahiro, Melki Dimitri, Saab Jad, Romanos Michael, Ning Kylie, Almardini Michel, Castellino Andrea, Shin Eun Ji, Afghani Elham, Canto Marcia Irene, Goggins Michael
Аннотация
BACKGROUND: Obstructive sleep apnea (OSA) has been linked with increased cancer incidence and mortality. We hypothesized that OSA may be a risk factor for neoplastic progression among patients undergoing pancreatic cancer surveillance.
METHODS: Retrospective medical record review of two Johns Hopkins Hospital cohorts undergoing pancreas surveillance; patients with familial/genetic risk enrolled in the Cancer of the Pancreas Screening (CAPS) study and patients with incidentally detected pancreatic cysts, enrolled in the PCYST study. Time-to-progression to pancreatic ductal adenocarcinoma (PDAC) and neoplastic progression (either PDAC, high-grade dysplasia or pancreatic neuroendocrine tumor) were compared by OSA status, adjusting for covariates.
RESULTS: OSA was diagnosed prior to or during surveillance in 174 (19.5%) of 893 patients in CAPS and 376 (23.7%) of 1585 patients in the PCYST cohort. In the combined cohorts, OSA was associated with increased risk of progression to PDAC (unadjusted HR: 3.12, 95% CI: [1.82, 5.34], p < 0.001). OSA was also associated with male sex, higher BMI, fatty liver, fatty pancreas, diabetes, and history of smoking (all p < 0.01). After covariate adjustment, OSA remained associated with PDAC risk (adjusted HR: 2.56 [1.44, 4.55], p = 0.001). Factors associated with neoplastic progression included OSA (adjusted HR: 1.93 [1.25, 2.97], p = 0.003), increasing age (age-per 5-years adjusted HR: 1.14 [1.05, 1.24], p = 0.003), fatty liver (adjusted HR: 1.76 [1.19, 2.60], p = 0.005), and diabetes (adjusted HR: 1.77 [1.16, 2.71], p = 0.008).
CONCLUSIONS: Patients undergoing pancreatic surveillance for their familial/genetic risk and/or incidentally detected pancreatic cysts have a greater likelihood of developing pancreatic cancer if they've been diagnosed with OSA.
METHODS: Retrospective medical record review of two Johns Hopkins Hospital cohorts undergoing pancreas surveillance; patients with familial/genetic risk enrolled in the Cancer of the Pancreas Screening (CAPS) study and patients with incidentally detected pancreatic cysts, enrolled in the PCYST study. Time-to-progression to pancreatic ductal adenocarcinoma (PDAC) and neoplastic progression (either PDAC, high-grade dysplasia or pancreatic neuroendocrine tumor) were compared by OSA status, adjusting for covariates.
RESULTS: OSA was diagnosed prior to or during surveillance in 174 (19.5%) of 893 patients in CAPS and 376 (23.7%) of 1585 patients in the PCYST cohort. In the combined cohorts, OSA was associated with increased risk of progression to PDAC (unadjusted HR: 3.12, 95% CI: [1.82, 5.34], p < 0.001). OSA was also associated with male sex, higher BMI, fatty liver, fatty pancreas, diabetes, and history of smoking (all p < 0.01). After covariate adjustment, OSA remained associated with PDAC risk (adjusted HR: 2.56 [1.44, 4.55], p = 0.001). Factors associated with neoplastic progression included OSA (adjusted HR: 1.93 [1.25, 2.97], p = 0.003), increasing age (age-per 5-years adjusted HR: 1.14 [1.05, 1.24], p = 0.003), fatty liver (adjusted HR: 1.76 [1.19, 2.60], p = 0.005), and diabetes (adjusted HR: 1.77 [1.16, 2.71], p = 0.008).
CONCLUSIONS: Patients undergoing pancreatic surveillance for their familial/genetic risk and/or incidentally detected pancreatic cysts have a greater likelihood of developing pancreatic cancer if they've been diagnosed with OSA.