Association between incident cancer and subsequent stroke. Issue 2 (7th January 2015)

• Record Type: Journal Article
• Authors: Navi, Babak B.; Reiner, Anne S.; Kamel, Hooman; Iadecola, Costantino; Elkind, Mitchell S. V.; Panageas, Katherine S.; DeAngelis, Lisa M.
• Is Part Of: Annals of neurology. Volume 77:Issue 2(2015:Feb.)
• Page Start: 291
• Page End: 300
• Publication Date: 2015-01-07
• Subjects: Neurology -- Periodicals; Pediatric neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; 616.8
• DOI: 10.1002/ana.24325
• Languages: English
• ISSNs: 0364-5134

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ana24325-sec-0001" sec-type="section"> <title>Objective</title> <p>A study was undertaken to examine the association between incident cancer and the subsequent risk of stroke.</p> </sec> <sec id="ana24325-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="ana24325-sec-0003" sec-type="section"> <title>Results</title> <p>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 (<italic>p</italic> < 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 (<italic>p</italic> < 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 (<italic>p</italic> < 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 (<italic>p</italic> < 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 (<italic>p</italic> = 0.085). Excess risks attenuated over time and were generally no longer present beyond 1 year.</p> </sec> <sec id="ana24325-sec-0004" sec-type="section"> <title>Interpretation</title> <p>Incident cancer is associated with an increased short‐term risk of stroke. This risk appears highest with lung, pancreatic, and colorectal cancers. Ann Neurol 2015;77:291–300</p> </sec> </abstract>