Association Between Obstructive Sleep Apnea and Urinary Tract Cancer: Data from Vercelli Registry

Obstructive Sleep Apnea (OSA) is associated with several comorbidities, including renal dysfunction, which may improve with C-PAP therapy. Sleep fragmentation and nocturnal hypoxia in OSA have been hypothesized to contribute to carcinogenesis, particularly affecting hypoxia-sensitive urinary tract cells. The aim of the present study was to assess cancer prevalence in OSA patients and explore clinical profiles of those with urinary tract cancer. We retrospectively analyzed 50 OSA patients with cancer from the Vercelli Hospital Registry. Cancer diagnoses were collected at the time of OSA diagnosis, prior to C-PAP initiation. 70% of patients were male. Among OSA-cancer patients, 34% had urinary tract cancer (88% males, p<0.05), followed by breast (14%), colorectal (12%), lung (10%), laryngeal and skin (8%), intracranial (6%), hematologic and parotid (4%), and others (2%). 10% had multiple cancer sites. Hierarchical clustering revealed a distinct profile: urinary tract cancer associated with better respiratory indices, frequent hypertension and higher C-PAP compliance. Our findings show a higher prevalence of urinary tract cancer in male OSA patients, suggesting a possible link between OSA-related hypoxia and carcinogenesis. This supports increased clinical surveillance and further research into whether OSA is a modifiable cancer risk factor. PAP therapy may offer protective benefits.