title: Obstructive sleep apnea is associated with an increased risk of colorectal neoplasia.
abstract: OBJECTIVE
  A recent meta-analysis showed that obstructive sleep apnea (OSA) is associated with a higher prevalence of cancer and cancer-related mortality; however, little information is available on the association between OSA and colorectal neoplasia.
  
  
  METHODS
  We identified consecutive patients who underwent overnight polysomnography (PSG) and subsequent colonoscopy. We compared the prevalence of colorectal neoplasia between patients with or without OSA according to the results of PSG. For each patient with OSA, 1 or 2 controls matched for age (±5 years), sex, body mass index (BMI), and smoking who had undergone first-time screening colonoscopy were selected.
  
  
  RESULTS
  Of the 163 patients, 111 patients were diagnosed with OSA and 52 patients were within the normal range of the Apnea-Hypopnea Index. Of the 111 patients with OSA, 18 patients (16.2%) had advanced colorectal neoplasia, including 4 (3.6%) colorectal cancers. In the multivariate analyses, OSA was associated with an increased risk of advanced colorectal neoplasia after adjusting for factors including age and sex (mild: odds ratio [OR], 14.09; 95% confidence interval [CI], 1.55-127.83; P = .019; moderate or severe: OR, 14.12; 95% CI, 1.52-131.25; P = .020). Our case-control study revealed that the odds of detecting advanced colorectal neoplasia among patients with OSA were approximately 3.03 times greater than in the controls matched for age, sex, BMI, and smoking (OR, 3.03; 95% CI, 1.44-6.34; P = .002).
  
  
  CONCLUSIONS
  Physicians should be aware of the association between OSA and the development of colorectal neoplasia and explain the need for colonoscopy to patients with OSA.
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Seohui
authors: S
authors: Lee
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Byeong Gwan
authors: BG
authors: Kim
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Ji Won
authors: JW
authors: Kim
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Kook Lae
authors: KL
authors: Lee
authors: Department of Neurology, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Dae Lim
authors: DL
authors: Koo
authors: Department of Neurology, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Hyunwoo
authors: H
authors: Nam
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Jong Pil
authors: JP
authors: Im
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Joo Sung
authors: JS
authors: Kim
authors: Division of Gastroenterology, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Seong-Joon
authors: SJ
authors: Koh
mesh_terms: D000236:Adenoma / Q000453:epidemiology* / Q000473:pathology; D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002277:Carcinoma / Q000453:epidemiology* / Q000473:pathology; D016022:Case-Control Studies; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*