Κυριακή 6 Δεκεμβρίου 2020

Risk of stroke in cancer survivors.

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Risk of stroke in cancer survivors.

Neurology. 2020 Dec 04;:

Authors: Zhang F, Wang K, Du P, Yang W, He Y, Li T, Mei Z

Abstract
OBJECTIVE: Accumulating evidence suggests that cancer survivors may have a relatively higher risk of stroke. The hypothesis of this meta-analysis was to determine whether cancer survivors have a relatively higher risk of stroke than non-cancer populations based on the published data from population-based cohort studies.
METHODS: Pubmed, Embase and Cochrane Library were searched from inception to February 8, 2020 for population-based cohort studies. Effect estimates with 95% CIs were pooled using the random-effects model. We conducted subgroup analyses and meta-regression to explore sources of heterogeneity and the stability of the results.
RESULTS: Twenty population-based cohort studies involving 10,479,530 participants were identified. Overall, the RR for stroke in cancer survivors was 1.66 (95% CI, 1.35-2.04; p < 0.001) compared with that in non-cancer controls, among which survivors of head and neck, hematologic, lung, pancreas and stomach cancer (all p < 0.05) showed consistent significant results, whereas no significant increased risk was observed for other cancer types. The effects were more prominent in cancer survivors with female gender (RR 1.38, 1.18-1.61; p < 0.001), younger age at cancer diagnosis (<45 years) (RR 2.57, 95% CI, 1.27-5.19; p = 0.009) and shorter cancer survival duration (≥1-2 years) (RR 1.69, 95% CI, 1.18-2.42; p = 0.004). Moreover, cancer survivors had a significantly increased risk of ischemic stroke (RR 1.53, 95% CI, 1.28-1.84; p < 0.001) compared with hemorrhagic stroke.
CONCLUSIONS: Cancer plays a critical role in the etiologic of stroke. Due to the existence of substantial heterogeneity among the included studies, the results should be interpreted with caution. However, early prevention and effective intervention of stroke in cancer survivors requires attention from the health policy makers.

PMID: 33277416 [PubMed - as supplied by publisher]

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