목적: Thyroid carcinoma and obstructive sleep apnea (OSA) are prevalent public health problems. Hypoxia in OSA is a postulated carcinogen based on epidemiological associations with all-cancer incidence and in-vivo biological models. At present, the association of OSA diagnosis with risk of developing thyroid carcinoma is unclear. 방법:This systematic review and meta-analysis was registered on PROSPERO and conducted in adherence to the PRISMA guidelines. Observational and randomized studies of associations of OSA with thyroid carcinoma incidence and mortality in adults, from four databases were searched. Random-effects meta-analyses and the population attributable fraction (PAF) from published global OSA prevalence estimates were computed. 결과:We included four studies with a combined cohort of 2,839,325 participants, all with moderate/low risk of bias. OSA diagnosis was associated with greater than twofold incidence of thyroid carcinoma (pooled HR 2.32, 95% CI 1.35-3.98, I2 = 95%), after multi-adjustment for demographics, BMI, smoking, alcohol, and comorbidities. Subgroup analysis of studies with at least 5 years of follow-up showed a stronger association of OSA with thyroid cancer incidence (pooled HR 3.27, 95% CI 2.80-3.82, I2 = 0%). The global population-attributable fraction of incident thyroid carcinoma associated with OSA was 14.5% (95% CI 4.29- 27.6%). 결론:OSA is associated with higher thyroid carcinoma incidence, though causation cannot be proven currently. Further biological and clinical studies should investigate OSA severity in relation to thyroid carcinoma progression and mortality, stratified by tumor histology.