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Temporal trends and risk factors associated with stroke mortality among cancer patients.

Yaman B Ahmed¹, Amy Shi Nan Feng², Mohammad Alrawashdeh³

¹Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Division of Neuroscience Critical Care, Departments of Neurosurgery, Anesthesiology, Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, MD 21287, USA.

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Summary

This summary is machine-generated.

Stroke death (SD) risk in cancer patients has declined, but remains elevated for younger individuals and those untreated. Older age, non-white race, and specific cancers like nervous system, respiratory, and head and neck increase SD risk.

Keywords:

Cancer Risk factors SEER Standardized mortality ratio Stroke mortality

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Area of Science:

Oncology
Epidemiology
Public Health

Background:

Cancer patients face an elevated risk of stroke death (SD) compared to the general population.
Understanding SD rates and risk factors is crucial for improving cancer patient outcomes.

Purpose of the Study:

To investigate the risk and incidence rates of stroke death (SD) in a large cohort of cancer patients.
To identify demographic and clinical factors associated with an increased risk of SD among cancer survivors.

Main Methods:

Retrospective analysis of 5,922,533 patients from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) registries (2000-2020).
Calculation of standardized mortality ratios (SMR) and incidence rates for SD, with annual percentage change (APC) analysis.
Multivariable Cox proportional hazards models were used to identify risk factors for SD.

Main Results:

Over 5.9 million cancer patients were included, with 56,686 (2.0%) deaths attributed to stroke.
Younger patients (≤39 years) and those receiving no cancer treatment exhibited the highest SMR for SD.
Increased SD risk was associated with older age, male sex, non-white race, and specific cancer types (nervous system, respiratory, head and neck).
Chemotherapy and radiotherapy were associated with a reduced risk of SD.

Conclusions:

Stroke death (SD) rates have decreased over time across all demographics and cancer types.
Significant risk factors for SD in cancer patients include older age, non-white race, and diagnoses of nervous system, respiratory, or head and neck cancers.
Targeted interventions and continued research are needed to mitigate SD risk in vulnerable cancer patient populations.