Increased risk for cancer after stroke at a young age: etiological relevance or incidental finding?

J Cancer Res Clin Oncol. 2019 Dec;145(12):3047-3054. doi: 10.1007/s00432-019-03022-x. Epub 2019 Sep 10.

Abstract

Background: Etiological factors, such as a malignant disease, in young stroke patients are often neglected. Therefore, in this study, we aimed to investigate the risk of developing cancer in young stroke survivors.

Methods: The current case-control study sample included patients who received an initial ischemic stroke diagnosis documented in the Disease Analyzer database (IQVIA), which compiles data such as risk factors, drug prescriptions, and diagnoses obtained from general practitioners and specialists.

Results: The stroke and non-stroke groups included 18,668 patients each; each group had 2836 (15.3%) participants ≤ 55 years. The cancer incidence in the stroke group over the age of 55 years was higher than in the younger subgroup (29.4% versus 17.3%). The proportions of cancer patients within 10 years of follow-up were higher in the stroke group versus the non-stroke group, as well as in the subgroup of patients aged ≤ 55 versus patients > 55 years (17.3% versus 9.5% and 29.4% versus 24.9%, respectively). The calculated hazard ratio for developing cancer within 10 years of follow-up was higher in the younger stroke population (≤ 55 years) than in the older population (hazard ratio: 1.47 (CI 1.18-1.83) versus 1.17 (CI 1.10-1.25).

Conclusion: In our cohort, young individuals aged ≤ 55 years who suffered a stroke had twice as high risk for developing cancer within 10 years after the index event compared to the control group. Stroke might have implication regarding the subsequent development of cancer and vice versa.

Keywords: Cancer; Stroke etiology; Young stroke.

MeSH terms

  • Case-Control Studies
  • Cohort Studies
  • Female
  • Humans
  • Incidence
  • Incidental Findings
  • Male
  • Middle Aged
  • Neoplasms / etiology*
  • Proportional Hazards Models
  • Risk Factors
  • Stroke / complications*
  • Survivors