Is stroke incidence increased in survivors of adult cancers? A systematic review and meta-analysis.
Adult cancer
Stroke
Survivorship
Systematic review
Journal
Journal of cancer survivorship : research and practice
ISSN: 1932-2267
Titre abrégé: J Cancer Surviv
Pays: United States
ID NLM: 101307557
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
received:
27
07
2021
accepted:
13
10
2021
pubmed:
6
11
2021
medline:
5
11
2022
entrez:
5
11
2021
Statut:
ppublish
Résumé
Existing research hints that people living with and beyond cancer are at an increased risk of stroke. However, there is insufficient evidence to appropriately inform guidelines for specific stroke prevention or management for cancer patients. We conducted a systematic review and meta-analysis to describe and quantify stroke incidence in people living with and beyond cancer. Medline, CINAHL, and EMBASE were searched for epidemiological studies comparing stroke incidence between cancer and non-cancer patients. Reviewers independently extracted data; random-effects meta-analyses and quality assessment were performed. Thirty-six studies were narratively synthesised. Meta-analysis was conducted using seven studies. Methodological quality was high for most studies. Study populations were heterogeneous, and the length of follow-up and risk factors varied. There was a variation in risk between different cancer types and according to stroke type: pancreatic (HR 2.85 (95% CI 2.43-3.36), ischaemic) (HR 2.28 (95% CI 1.43-3.63), haemorrhagic); lung (HR 2.33 (95% CI 1.63-3.35), ischaemic) (HR 2.14 (95% CI 1.45-3.15), haemorrhagic); and head and neck (HR 1.54 (95% CI 1.40-1.69), haemorrhagic) cancers were associated with significantly increased incidence of stroke. Risk is highest within the first 6 months of diagnosis. Narrative synthesis indicated that several studies also showed significantly increased incidence of stroke in individuals with colorectal cancer, breast cancer, ovarian cancer, nasopharyngeal cancer, leukaemia, and myeloma, and those who have received radiotherapy for head and neck cancers and platinum-based chemotherapy may also have higher stroke incidence. Stroke incidence is significantly increased after diagnosis of certain cancers. Cardiovascular risk should be assessed during cancer survivorship care, with attention to modifying shared cancer/cardiovascular risk factors.
Identifiants
pubmed: 34739710
doi: 10.1007/s11764-021-01122-7
pii: 10.1007/s11764-021-01122-7
pmc: PMC9630245
doi:
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1414-1448Subventions
Organisme : Chief Scientist Office
ID : HIPS/19/21
Pays : United Kingdom
Informations de copyright
© 2021. The Author(s).
Références
Radiat Oncol. 2013 Feb 28;8:41
pubmed: 23448602
Stroke. 2010 Apr;41(4):798-801
pubmed: 20150545
Blood Coagul Fibrinolysis. 2017 Jan;28(1):72-82
pubmed: 26919453
Cancer. 1978 Jan;41(1):130-7
pubmed: 626923
J Stroke Cerebrovasc Dis. 2017 Apr;26(4):809-815
pubmed: 27890440
J Neurooncol. 2013 Feb;111(3):295-301
pubmed: 23299460
Lancet. 2019 Sep 21;394(10203):1041-1054
pubmed: 31443926
Neurology. 2021 Jan 26;96(4):e513-e526
pubmed: 33277416
Clin Neurol Neurosurg. 2006 Feb;108(2):150-6
pubmed: 16412836
J Clin Oncol. 2016 Apr 1;34(10):1122-30
pubmed: 26834065
Ann Neurol. 2015 Feb;77(2):291-300
pubmed: 25472885
Neurology. 2004 Oct 12;63(7):1230-3
pubmed: 15477543
J Physiol Biochem. 2012 Sep;68(3):455-60
pubmed: 22371015
Arch Gynecol Obstet. 2013 Oct;288(4):867-71
pubmed: 23568013
Gynecol Oncol. 2013 May;129(2):346-52
pubmed: 23422502
Br J Cancer. 2012 Sep 25;107(7):1195-202
pubmed: 22892390
Urol Int. 2020;104(3-4):214-221
pubmed: 31747673
Int J Neurosci. 2015;125(11):808-16
pubmed: 25233149
Gynecol Oncol. 2009 May;113(2):240-4
pubmed: 19251310
Front Neurol. 2019 Mar 15;10:233
pubmed: 30930843
Medicine (Baltimore). 2018 Mar;97(11):e0133
pubmed: 29538211
J Clin Oncol. 2020 Feb 20;38(6):584-592
pubmed: 31821065
Int J Radiat Oncol Biol Phys. 2017 Feb 1;97(2):278-286
pubmed: 28068236
J Clin Oncol. 2010 Jul 20;28(21):3448-56
pubmed: 20567006
J Neurol Transl Neurosci. 2014;2(1):1039
pubmed: 26322334
Eur J Cancer. 2005 Feb;41(3):423-9
pubmed: 15691643
Int J Radiat Oncol Biol Phys. 2010 Dec 1;78(5):1337-44
pubmed: 20350792
J Neurol. 2016 Jan;263(1):150-6
pubmed: 26530513
Int J Radiat Oncol Biol Phys. 2011 Dec 1;81(5):e833-8
pubmed: 21570205
J Clin Oncol. 2002 Jan 1;20(1):282-8
pubmed: 11773180
PLoS One. 2014 Jul 15;9(7):e102484
pubmed: 25025282
Eur J Cancer. 2012 Aug;48(12):1875-83
pubmed: 22296948
BMC Med. 2014 Mar 25;12:53
pubmed: 24661584
Blood. 2006 Apr 1;107(7):2912-9
pubmed: 16339404
Laryngoscope. 2002 Oct;112(10):1883-7
pubmed: 12368635
Expert Rev Neurother. 2012 Apr;12(4):363-5
pubmed: 22449208
Front Neurol. 2019 Jun 07;10:579
pubmed: 31231302
Ann Intern Med. 2015 Jun 2;162(11):777-84
pubmed: 26030634
Nat Commun. 2019 Nov 15;10(1):5172
pubmed: 31729378
Stroke. 2018 Jul;49(7):1585-1592
pubmed: 29866752
Br J Cancer. 2011 Oct 25;105(9):1419-23
pubmed: 21915128
Clin Otolaryngol. 2013 Feb;38(1):39-47
pubmed: 23194286
Eur J Endocrinol. 2019 Jan 1;180(1):11-20
pubmed: 30400044
BMC Cancer. 2016 Mar 03;16:180
pubmed: 26940836
Stroke. 2012 Nov;43(11):3035-40
pubmed: 22968468
Lung. 2013 Oct;191(5):501-9
pubmed: 23807721
J Thromb Haemost. 2019 Aug;17(8):1305-1318
pubmed: 31054195
Am J Med. 2017 Dec;130(12):1440-1448.e1
pubmed: 28739198
J Am Coll Cardiol. 2017 Aug 22;70(8):926-938
pubmed: 28818202
J Clin Oncol. 2006 Dec 1;24(34):5388-94
pubmed: 17088569
Int J Cancer. 2012 Jan 15;130(2):478-87
pubmed: 21387298
Acta Oncol. 2010 Apr;49(3):287-97
pubmed: 20156114
Thromb Haemost. 2011 Jul;106(1):149-55
pubmed: 21614410
Ann Neurol. 2018 May;83(5):873-883
pubmed: 29633334
Medicine (Baltimore). 2015 Sep;94(37):e1336
pubmed: 26376378
Stroke. 2011 Sep;42(9):2410-8
pubmed: 21817150
J Natl Cancer Inst. 2018 Dec 1;110(12):1342-1351
pubmed: 29741696
Cancer Med. 2018 Oct;7(10):4952-4963
pubmed: 30220107
J Natl Cancer Inst. 2009 Jul 1;101(13):928-37
pubmed: 19535773
Ann Surg Oncol. 2018 Oct;25(11):3248-3256
pubmed: 30043317
Sci Rep. 2020 Jun 25;10(1):10313
pubmed: 32587285
Stroke. 2011 Nov;42(11):3034-9
pubmed: 21903961
Br J Cancer. 2019 May;120(11):1067-1074
pubmed: 31065112
Eur J Cancer. 2012 Jan;48(1):121-8
pubmed: 22023886