Risk factor for colorectal neoplasms: obstructive sleep apnea or nocturnal hypoxemia?

The objective of this study is to determine whether nocturnal hypoxemia, as compared to obstructive sleep apnea (OSA), serves as a risk factor for colorectal neoplasia, encompassing colorectal cancer (CRC), adenomas, and advanced adenomas.

We conducted a study involving individuals who underwent both standard polysomnography (PSG) and colonoscopy. Analyses included the univariate and multivariate logistic regression analyses, receiver operating characteristic (ROC) curve analyses, subgroup analysis and sensitivity analysis.

In this study, a total of 335 individuals were included. Univariate logistic regression analyses revealed that age, family history of CRC, waistline and hypoxemia were associated with colorectal neoplasm and adenoma, where OSA did not show the association with colorectal neoplasm and adenoma. After adjusted covariates, severe and moderate hypoxemia still maintained the independent association with occurrence of colorectal neoplasm [moderate vs. none: odds ratio (OR) 5.02, 95% confidence interval (CI) 1.39-24.68, p = 0.024; severe vs. none: OR 4.07, 95% CI 1.16-19.66, p = 0.046] and adenoma (moderate vs. none: OR 5.02, 95% CI 1.39-24.68, p = 0.024; severe vs. none: OR 4.07, 95% CI 1.16-19.66, p = 0.046). Among stratified analyses, nocturnal hypoxemia still remained as an independent adverse predictor for colorectal neoplasm, among individuals aged 40 and older, without overweight, hypertension and smoking habits.

Nocturnal hypoxemia is associated with occurrence of colorectal neoplasms, especially moderate and severe hypoxemia. Across various subgroups, hypoxemia still remained as an independent adverse predictor for colorectal neoplasm, among individuals aged 40 and older, without overweight, hypertension and smoking habits.