Incidence of stroke in the first year after diagnosis of cancer—A systematic review and meta-analysis

Ronda Lun*, Danielle Carole Roy, Yu Hao, Rishi Deka, Wen Kuan Huang, Babak B. Navi, Deborah M. Siegal, Tim Ramsay, Dean Fergusson, Risa Shorr, Dar Dowlatshahi

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

Background: Patients newly diagnosed with cancer represent a population at highest risk for stroke. The objective of this systematic review and meta-analysis was to estimate the incidence of stroke in the first year following a new diagnosis of cancer. Methods: We searched MEDLINE and EMBASE from January 1980 to June 2021 for observational studies that enrolled adults with a new diagnosis of all cancers excluding non-melanoma skin cancer, and that reported the incidence of stroke at 1 year. PRISMA guidelines for meta-analyses were followed. Two reviewers independently extracted data and appraised risk of bias. We used the Dersimonian and Laird random effects method to pool cumulative incidences after logit transformation, and reported pooled proportions as percentages. Statistical heterogeneity was assessed using the I2 statistic. Results: A total of 12,083 studies were screened; 41 studies were included for analysis. Data from 2,552,121 subjects with cancer were analyzed. The cumulative incidence of total stroke at 1 year was 1.4% (95% CI 0.9–2.2%), while the pooled incidence of ischemic stroke was 1.3% (95% CI 1.0–1.8%) and 0.3% (95% CI 0.1–0.9%) for spontaneous intracerebral hemorrhage (ICH), with consistently high statistical heterogeneity (>99% I2). Conclusion: The estimated incidence of stroke during the first year after a new diagnosis of cancer is 1.4%, with a higher risk for ischemic stroke than ICH. Cancer patients should be educated on the risk of stroke at the time of diagnosis. Future studies should evaluate optimal primary prevention strategies in this high-risk group of patients. Systematic review registration: https://osf.io/ucwy9/.

Original languageEnglish
Article number966190
JournalFrontiers in Neurology
Volume13
DOIs
StatePublished - 20 09 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 Lun, Roy, Hao, Deka, Huang, Navi, Siegal, Ramsay, Fergusson, Shorr and Dowlatshahi.

Keywords

  • cancer
  • epidemiology
  • incidence
  • meta-analysis
  • population health
  • risk
  • stroke
  • systematic review

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