Association between incident cancer and subsequent stroke Journal Article

Authors: Navi, B. B.; Reiner, A. S.; Kamel, H.; Iadecola, C.; Elkind, M. S. V.; Panageas, K. S.; Deangelis, L. M.
Article Title: Association between incident cancer and subsequent stroke
Abstract: Objective: A study was undertaken 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.
Keywords: cancer survival; controlled study; aged; major clinical study; hypertension; cancer patient; pancreas cancer; cancer staging; outcome assessment; follow up; cancer diagnosis; cancer incidence; colorectal cancer; disease association; breast cancer; cohort analysis; lung cancer; retrospective study; risk assessment; prostate cancer; medicare; comorbidity; cancer registry; brain ischemia; heart atrium fibrillation; brain hemorrhage; cerebrovascular accident; race; charlson comorbidity index; human; male; female; priority journal; article
Journal Title: Annals of Neurology
Volume: 77
Issue: 2
ISSN: 0364-5134
Publisher: Wiley Blackwell  
Date Published: 2015-02-01
Start Page: 291
End Page: 300
Language: English
DOI: 10.1002/ana.24325
PROVIDER: scopus
PMCID: PMC4315703
PUBMED: 25472885
Notes: Export Date: 2 March 2015 -- Source: Scopus
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MSK Authors
  1. Anne S Reiner
    122 Reiner
  2. Katherine S Panageas
    331 Panageas
  3. Babak Navi
    15 Navi