Association between Incident Cancer and Subsequent Stroke

作者：Navi Babak B^*; Reiner Anne S; Kamel Hooman; Iadecola Costantino; Elkind Mitchell S V; Panageas Katherine S; DeAngelis Lisa M

来源：Annals of Neurology, 2015, 77(2): 291-300.

DOI：10.1002/ana.24325

ObjectiveA study was undertaken to examine the association between incident cancer and the subsequent risk of stroke.
MethodsUsing 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.
ResultsAmong 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.
InterpretationIncident 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

• 出版日期2015-2