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Incident cancer linked to increased short-term stroke risk
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Patients with a new cancer diagnosis have an elevated risk for subsequent stroke, according to study results.
Babak Navi, MD, assistant professor of neurology and neuroscience in the Feil Family Brain and Mind Research Institute at Weill Cornell Medical College and a neurologist at Memorial Sloan Kettering Cancer Center, and colleagues used the SEER–Medicare linked database to identify patients with a new primary diagnosis of breast, colorectal, lung, pancreatic or prostate cancer from 2001 to 2007.
Babak Navi
Patients were individually matched by age, sex, race, registry and medical comorbidities to a control group of Medicare enrollees without cancer, and each group was followed until 2009.
Researchers used validated diagnosis codes to identify a primary outcome of stroke, and they used competing risk survival statistics to calculate cumulative incidence rates.
The analysis included 327,389 pairs of patients with cancer and their matched controls.
Results showed 3-month cumulative incidence of stroke was higher in patients with cancer.
Cumulative incidence rates were 5.1% (95% CI, 4.9-5.2) in patients with lung cancer vs. 1.2% (95% CI, 1.2-1.3) in the matched control group (P < .001); 3.4% (95% CI, 3.1-3.6) in patients with pancreatic cancer vs. 1.3% (95% CI, 1.1-1.5) in the matched control group (P < .001); 3.3% (95% CI, 3.2-3.4) in patients with colorectal cancer vs. 1.3% (95% CI, 1.2-1.4) in the matched control group (P < .001); 1.5% (95% CI, 1.4-1.6) in patients with breast cancer vs. 1.1% (95% CI, 1-1.2) in the matched control group (P < .001); and 1.2% (95% CI, 1.1-1.3) in patients with prostate cancer vs. 1.1% (95% CI, 1-1.2) in the matched control group.
Excess risks decreased with time and, in general, did not persist beyond 1 year.
Researchers found that patients with more aggressive cancers had an increased risk for subsequent stroke, according to a press release.
“We found that patients with cancer face a heightened risk of stroke, especially in the first few months after their cancer is diagnosed,” Navi told HemOnc Today. “We had hypothesized that this might be the case because cancer can cause abnormalities in the blood clotting system, which often puts patients at risk of forming blood clots. The implications of our findings are that patients with cancer need to be vigilant about the signs and symptoms of stroke and should seek immediate medical attention if they occur. Also, patients with cancer should work with their physicians to make sure that their other stroke risk factors (eg, diabetes and hypertension) are as well controlled as possible. These findings apply to a large group of people — approximately 1.6 million people receive a diagnosis of cancer each year in the U.S.” – by Lauren Frisby
For more information:
Babak B. Navi, MD, can be reached at Department of Neurology, 525 E. 68th St., F610, New York, NY 10065; email: ban9003@med.cornell.edu.
Disclosure: The researchers report no relevant financial disclosures.
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