Ischemic Stroke Patients May Be at Higher Risk of Cancer

NASHVILLE — New results indicate that patients with ischemic stroke are more likely to develop cancer than those of the general population, and that those who develop the disease have a threefold greater risk for mortality.

The study was presented at the International Stroke Conference 2015.

In all, the randomized, double blind VISP study included 3,680 adults with non-disabling cerebral infarction. Researchers followed patients for two years and determined age-adjusted rates of cancer incidence among ischemic stroke patients compared with the general population. At enrollment, 3,247 patients (mean age, 66 ± 11 years; 62% men) were free of cancer.

During follow-up, incidence of cancer (per 100 patients) was 0.15 at one month, 0.8 at six months, 1.2 at one year and 2 at two years, with 133 patients developing cancer during the two-year study period.

At one year, the age-adjusted annual rate of cancer was 581.8/100,000 persons for patients with ischemic stroke compared with 486.5/100,000 persons in the general population (standardized incidence ratios [SIR]=1.2; 95% CI 1.16-1.24).

Similarly, at two years, the age-adjusted annual rate of cancer was also higher among patients with ischemic stroke (1,301.7/100,000 vs. 911.5/100,000; SIR=1.4; 95% CI 1.2-1.6).

According to study lead author Malik Adil, MD, from the Zeenat Qureshi Stroke Institute in St. Cloud, Minnesota, this observed link is mainly due to the blood of cancer patients, which tends to clot more often. “In addition, when tissues get less oxygen due to blocked blood vessels, it destroys tissue cells and sets off a series of events to alter the normal physiology and may lead to cancer,” Adil said in a press release.

Furthermore, after adjusting for potential confounders, the study also found that patients who developed cancer were at a higher risk for death (OR=3.1; 95% CI, 1.8-5.4), fatal/disabling stroke or death (OR=2.3; 95% CI 1.4-3.7), and a composite endpoint of stroke, coronary heart disease, and/or death (OR=1.4; 95% CI, 1.0-2.2) than those who were free of cancer.

In his presentation, Adil said that future research is needed to define the subset of patients who could benefit from cancer screening, as well as to determine whether such screening can reduce long-term mortality among stroke survivors.

For more coverage of the International Stroke Conference 2015, go here.

Reference

1. Adil M et al. Abstract 210. Presented at: International Stroke Conference 2015; Feb. 11-13, 2015; Nashville, Tennessee.