1006 Sleep Problems and Risk of Cancer Incidence and Mortality in the Cardiovascular Health Study (CHS)

Abstract Introduction Even in the absence of a formal diagnosis, sleep problems (SP) are frequently indicative of an underlying sleep disorder, such as obstructive sleep apnea, which may be adversely associated with cancer risk and cancer outcomes. Methods We assessed the association of self-reported SP with incident cancer (N=4,997, excluding prevalent cancers) and cancer mortality (N=5849) among the participants of Cardiovascular Health Study (CHS), a population-based study of adults aged >=65 years recruited from 4 US communities. Participants reported SP (daytime sleepiness, observed apnea and snoring) yearly from 1989-1994; these self-reported symptoms have been validated against objective sleep measures assessed within a subset of CHS participants (n= 1240) who received a home polysomnography as part of the Sleep Heart Health Study. Cancer incidence was ascertained through linkage with state cancer registries through 2005; cancer specific death was adjudicated through 2015. We used Cox proportional hazards regression to calculate hazard ratios (HR) and 95% confidence intervals (CI) for associations of baseline SP with subsequent cancer incidence and cancer mortality, adjusting for baseline sociodemographics, lifestyle factors, and medical history. Results The mean age (SD) of the study population was 73 (6) years, 56% were female, and 84% were white. The prevalence of SP was 17% for daytime sleepiness, 8% for observed apnea, and 24% for snoring; 63% reported none of the 3 SP. Overall, 1,130 first incident cancers and 1,014 cancer deaths were identified over median follow-up of 12 and 13 years, respectively. Compared to participants who reported no SP, the risk of incident cancer was inversely associated with daytime sleepiness (HR 0.86 [95% CI 0.70-1.04]), observed apnea (HR 0.74 [0.56-1.00]), and snoring (HR 0.80 [0.68-0.95]). Cancer mortality HR (95% CI) estimates were 1.00 (0.82-1.21) for daytime sleepiness, 0.77 (0.57-1.04) for observed apnea, and 0.88 (0.74, 1.04) for snoring. Conclusion Symptoms indicating SP reported at baseline were not associated with increased cancer incidence or cancer mortality. Ongoing analyses are focused on the impact of longitudinal SP (time dependent, cumulative average) to ensure an adequate latency period is incorporated into our analysis of the association between SP and cancer risk and mortality. Support NIHT32CA09488017

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Sleep problems and risk of cancer incidence and mortality in an older cohort: The Cardiovascular Health Study (CHS)

Cancer Epidemiology ◽

10.1016/j.canep.2021.102057 ◽

2022 ◽

Vol 76 ◽

pp. 102057

Author(s):

Arthur Sillah ◽

Nathaniel F. Watson ◽

Ulrike Peters ◽

Mary L. Biggs ◽

F. Javier Nieto ◽

...

Keyword(s):

Cancer Incidence ◽

Cardiovascular Health ◽

Sleep Problems ◽

Health Study ◽

Cardiovascular Health Study ◽

Incidence And Mortality ◽

Risk Of Cancer

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Cancer Incidence and Mortality in Patients Treated Either With RAI or Thyroidectomy for Hyperthyroidism

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2015-1874 ◽

2015 ◽

Vol 100 (10) ◽

pp. 3710-3717 ◽

Cited By ~ 32

Author(s):

Essi Ryödi ◽

Saara Metso ◽

Pia Jaatinen ◽

Heini Huhtala ◽

Rauni Saaristo ◽

...

Keyword(s):

Risk Factors ◽

Cancer Risk ◽

Respiratory Tract ◽

Cancer Incidence ◽

Cancer Mortality ◽

Hazard Ratio ◽

Risk Of Cancer ◽

Shared Risk ◽

Hyperthyroid Patients

Context: Some previous studies have suggested increased cancer risk in hyperthyroid patients treated with radioactive iodine (RAI). It is unclear whether the excess cancer risk is attributable to hyperthyroidism, its treatment, or the shared risk factors of the two diseases. Objective: The objective was to assess cancer morbidity and mortality in hyperthyroid patients treated with either RAI or surgery. Patients: We identified 4334 patients treated surgically for hyperthyroidism in Finland during 1986–2007 from the Hospital Discharge Registry and 1814 patients treated with RAI for hyperthyroidism at Tampere University Hospital. For each patient, three age- and gender-matched controls were chosen. Information on cancer diagnoses was obtained from the Cancer Registry. The follow-up began 3 months after the treatment and ended at cancer diagnosis, death, emigration, or the common closing date (December 31, 2009). Results: The overall cancer incidence was not increased among the hyperthyroid patients compared to their controls (rate ratio [RR], 1.05; 95% confidence interval [CI], 0.96–1.15). However, the risk of cancers of the respiratory tract (RR, 1.46; 95% CI, 1.05–2.02) and the stomach (RR, 1.64; 95% CI, 1.01–2.68) was increased among the patients. The overall cancer mortality did not differ between the patients and the controls (RR, 1.08; 95% CI, 0.94–1.25). The type of treatment did not affect the overall risk of cancer (hazard ratio for RAI vs thyroidectomy, 1.03; 95% CI, 0.86–1.23) or cancer mortality (hazard ratio, 1.04; 95% CI, 0.91–1.21). Conclusions: In this cohort of Finnish patients with hyperthyroidism treated with thyroidectomy or RAI, the overall risk of cancer was not increased, although an increased risk of gastric and respiratory tract cancers was seen in hyperthyroid patients. Based on this large-scale, long-term follow-up study, the increased cancer risk in hyperthyroid patients is attributable to hyperthyroidism and shared risk factors, not the treatment modality.

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Epigenome-wide association analysis of daytime sleepiness in the Multi-Ethnic Study of Atherosclerosis reveals African-American-specific associations

SLEEP ◽

10.1093/sleep/zsz101 ◽

2019 ◽

Vol 42 (8) ◽

Cited By ~ 4

Author(s):

Richard Barfield ◽

Heming Wang ◽

Yongmei Liu ◽

Jennifer A Brody ◽

Brenton Swenson ◽

...

Keyword(s):

Daytime Sleepiness ◽

Cardiovascular Health ◽

Association Studies ◽

Meta Analysis ◽

Health Study ◽

Cardiovascular Health Study ◽

P Value ◽

Uk Biobank ◽

Ethnic Study ◽

The Uk

AbstractStudy ObjectivesDaytime sleepiness is a consequence of inadequate sleep, sleep–wake control disorder, or other medical conditions. Population variability in prevalence of daytime sleepiness is likely due to genetic and biological factors as well as social and environmental influences. DNA methylation (DNAm) potentially influences multiple health outcomes. Here, we explored the association between DNAm and daytime sleepiness quantified by the Epworth Sleepiness Scale (ESS).MethodsWe performed multi-ethnic and ethnic-specific epigenome-wide association studies for DNAm and ESS in the Multi-Ethnic Study of Atherosclerosis (MESA; n = 619) and the Cardiovascular Health Study (n = 483), with cross-study replication and meta-analysis. Genetic variants near ESS-associated DNAm were analyzed for methylation quantitative trait loci and followed with replication of genotype-sleepiness associations in the UK Biobank.ResultsIn MESA only, we detected four DNAm-ESS associations: one across all race/ethnic groups; three in African-Americans (AA) only. Two of the MESA AA associations, in genes KCTD5 and RXRA, nominally replicated in CHS (p-value < 0.05). In the AA meta-analysis, we detected 14 DNAm-ESS associations (FDR q-value < 0.05, top association p-value = 4.26 × 10−8). Three DNAm sites mapped to genes (CPLX3, GFAP, and C7orf50) with biological relevance. We also found evidence for associations with DNAm sites in RAI1, a gene associated with sleep and circadian phenotypes. UK Biobank follow-up analyses detected SNPs in RAI1, RXRA, and CPLX3 with nominal sleepiness associations.ConclusionsWe identified methylation sites in multiple genes possibly implicated in daytime sleepiness. Most significant DNAm-ESS associations were specific to AA. Future work is needed to identify mechanisms driving ancestry-specific methylation effects.

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