title: Obstructive sleep apnea promotes cancer development and progression: a concise review.
abstract: BACKGROUND
  Obstructive sleep apnoea-hypopnoea (OSA) is an increasingly common sleep disorder which is widely accepted to be associated with high rates of morbidity and mortality. OSA is an independent risk factor for cardiovascular diseases, cerebrovascular disease, and metabolic disease. Recently, several studies have demonstrated that patients with OSA have a higher prevalence of cancer and cancer-related mortality. The epidemiological surveys suggest that patients with OSA had a higher incidence of cancer and cancer-related mortality than patients without OSA. Animal studies indicate that the activation of HIF-1 and VEGF pathways in response to intermittent hypoxia may promote the blood supply which supports tumor growth. In addition, tumor-associated macrophages may be altered by intermittent hypoxia (or sleep fragmentation) to a tumor-promoting phenotype yielding more aggressive cancer behavior.
  
  
  CONCLUSIONS
  The relationship between OSA and cancer has been confirmed, in which patients with OSA have a relative high prevalence of cancer and cancer-related mortality. The mechanism of OSA promoting cancer development and progression may be related with intermittent hypoxia and possibly sleep fragmentation. The activation of several cancer-related pathways may play an important role in tumor growth and metastasis. More clinical data and basic studies are needed to explain and confirm the relationship between OSA and cancer.
authors: Sleep Breathing Disorder Research Group, Department of Respiratory Medicine, Tianjin General Hospital, Tianjin Medical University, Anshan Road, Tianjin, 300052, China.
authors: Jie
authors: J
authors: Cao
authors: Jing
authors: J
authors: Feng
authors: Lian
authors: L
authors: Li
authors: Baoyuan
authors: B
authors: Chen
mesh_terms: D000818:Animals; D002423:Cause of Death; D003430:Cross-Sectional Studies; D004195:Disease Models, Animal; D018450:Disease Progression; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000502:physiology; D009369:Neoplasms / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D042461:Vascular Endothelial Growth Factor A / Q000502:physiology
chemical_list: C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D042461:Vascular Endothelial Growth Factor A
references: Proc Natl Acad Sci U S A. 2009 Nov 17;106(46):19485-90
references: 19887629
references: Eur Respir J. 2009 Jun;33(6):1467-84
references: 19483049
references: J Clin Sleep Med. 2007 Aug 15;3(5):467-72
references: 17803009
references: Int Heart J. 2005 Sep;46(5):801-9
references: 16272771
references: Breast Cancer Res. 2010;12(6):R94
references: 21067584
references: Sleep Med. 2012 Dec;13(10 ):1254-60
references: 23149216
references: Circulation. 1998 Jun 2;97(21):2154-9
references: 9626176
references: Curr Med Chem. 2012;19(1):90-7
references: 22300081
references: Toxicol Pathol. 2010 Jan;38(1):96-109
references: 20019356
references: J Neurol. 2006 Jun;253(6):746-52
references: 16511651
references: Am J Respir Crit Care Med. 2013 Jan 1;187(1):99-105
references: 23155146
references: Sleep. 1999 Mar 15;22(2):217-23
references: 10201066
references: Trends Pharmacol Sci. 2012 Apr;33(4):207-14
references: 22398146
references: PLoS One. 2014 Aug 14;9(8):e105104
references: 25122487
references: Sleep. 2013 Oct 01;36(10):1429-35
references: 24082302
references: Am J Respir Crit Care Med. 2014 Mar 1;189(5):593-601
references: 24471484
references: JAAPA. 2006 Nov;19(11):16-20
references: 17124787
references: Am J Respir Crit Care Med. 2012 Jul 15;186(2):190-4
references: 22610391
references: Cancer Lett. 2008 Jul 18;266(1):12-20
references: 18378391
references: Med Hypotheses. 2007;68(1):232
references: 16905275
references: Sleep. 2014 Apr 01;37(4):709-14, 714A-714T
references: 24688164
references: Circulation. 2008 Sep 2;118(10):1080-111
references: 18725495
references: Cancer Res. 2014 Mar 1;74(5):1329-37
references: 24448240
references: Eur Respir J. 2012 Jan;39(1):215-7
references: 22210813
references: Lancet. 2008 Feb 16;371(9612):569-78
references: 18280327
references: EMBO J. 2012 May 30;31(11):2448-60
references: 22562152
references: J Cell Biochem. 2010 Oct 15;111(3):554-63
references: 20568121
references: Proc Nutr Soc. 2008 Aug;67(3):253-6
references: 18452640
references: Respir Physiol Neurobiol. 2013 May 1;186(3):303-7
references: 23499797
references: Reprod Biomed Online. 2014 Jun;28(6):684-703
references: 24745838
references: Toxicol Appl Pharmacol. 2011 Jul 15;254(2):86-99
references: 21296097
references: Brain Res Bull. 2003 Jun 30;61(1):87-92
references: 12788211
references: Sleep Med. 2014 Jul;15(7):742-8
references: 24907033
references: Aging (Albany NY). 2011 Mar;3(3):304-10
references: 21389351
references: Sleep. 2013 May 01;36(5):681-8
references: 23633750
references: Adv Cardiol. 2011;46:67-138
references: 22005190
references: Rev Port Pneumol. 2003 Jul-Aug;9(4):327-35
references: 19771690