Stroke risk in cancer survivors: a systematic review and meta-analysis

Stroke; 56 (Suppl.1), 2025
Ano de publicação: 2025

BACKGROUND:

It is suggested that survivors of different types of cancer may have an increased risk of stroke. Our study aims to evaluate cancer patients and non-cancer controls by analyzing stroke events in each group. Previous studies concluded that certain types of cancer increased stroke risk, however, their results had significant heterogeneity and statistical concerns.

METHODS:

Medline, Embase, and Cochrane databases were systematically searched until February 18th, 2024, assessing stroke in cancer survivor patients compared to the global population. Data were examined using the Mantel-Haenszel method and 95% CIs. Heterogeneity was assessed using I2 statistics. Review Manager 5.4 was used for statistical analysis.

RESULTS:

A total of 18 studies were included, and stroke was reported in both cancer and non-cancer groups. Breast cancer (HR 1.09; 95% CI 1.02-1.17; p=0.01; I2= 0%), Central Nervous System cancers (HR 2.47; 95% CI 1.01-6.01; p=0.05; I2= 78%), cervical cancers (HR 1.58; 95% CI 1.19-2.09; p=0.001; I2= 0%), head and neck cancers (HR 1.34; 95% CI 1.07-1.68; p=0.01; I2= 59%), lung cancers (HR 1.60; 95% CI 1.40-1.83; p<0.00001; I2=67%), multiple myeloma (HR 1.58; 95% CI 1.32 -1.89; p<0.00001; I2= 49%), nasopharyngeal cancers (HR 1.72; 95% CI 1.28-2.30; p=0.0003; I2= 85%), oesophageal cancers (HR 1.33; 95% CI 1.07-1.65; p=0.009; I2= 0%), ovarian cancers (HR 1.33; 95% CI 1.07-1.65; p=0.01; I2= 38%), pancreatic cancers (HR 2,70; 95% CI 2.34-3.11; p<0.00001; I2= 0%) and rectum cancers (HR 1.29; 95% CI 1.01-1.63; p=0.04; I2= 0%) showed statistically significant differences between groups in favor of non-cancer controls.

CONCLUSIONS:

In this meta-analysis, the stroke risk was increased in all cancers that reached statistical significance. Furthermore, our study brings relevant data to the body of literature concerning this long-term clinical uncertainty.

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