Authors: Navi BB, Reiner AS, Kamel H, Iadecola C, Elkind MS, Panageas KS, DeAngelis LM
Title: Association between Incident Cancer and Subsequent Stroke.
Journal: Ann Neurol :-
Date: 2014 Dec 04
Abstract: Objective: To examine the association between incident cancer and the subsequent risk of stroke. Methods: Using the Surveillance Epidemiology and End Results-Medicare linked database, we identified patients with a new primary diagnosis of breast, colorectal, lung, pancreatic, or prostate cancer from 2001 through 2007. These patients were individually matched by age, sex, race, registry, and medical comorbidities to a group of Medicare enrollees without cancer, and each pair was followed through 2009. Validated diagnosis codes were used to identify a primary outcome of stroke. Cumulative incidence rates were calculated using competing risk survival statistics. Results: Among 327,389 pairs of cancer patients and matched controls, the 3-month cumulative incidence of stroke was generally higher in patients with cancer. Cumulative incidence rates were 5.1% (95% confidence interval [CI], 4.9-5.2%) in patients with lung cancer compared to 1.2% (95% CI, 1.2-1.3%) in controls (p<0.001), 3.4% (95% CI, 3.1-3.6%) in patients with pancreatic cancer compared to 1.3% (95% CI, 1.1-1.5%) in controls (p<0.001), 3.3% (95% CI, 3.2-3.4%) in patients with colorectal cancer compared to 1.3% (95% CI, 1.2-1.4%) in controls (p<0.001), 1.5% (95% CI, 1.4-1.6%) in patients with breast cancer compared to 1.1% (95% CI, 1.0-1.2%) in controls (p<0.001), and 1.2% (95% CI, 1.1-1.3%) in patients with prostate cancer compared to 1.1% (95% CI, 1.0-1.2%) in controls (p=0.085). Excess risks attenuated over time and were generally no longer present beyond 1 year. Interpretation: Incident cancer is associated with an increased short-term risk of stroke. This risk appears highest with lung, pancreatic, and colorectal cancers. This article is protected by copyright. All rights reserved.
Last Modified: 03 Sep 2013