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

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-04-18 DOI:10.1016/j.jocn.2025.111249

Yaman B. Ahmed , Amy Shi Nan Feng , Mohammad Alrawashdeh , Asmaa Ellaithy , Shivalika Khanduja , Majd M. AlBarakat , Sakhr Alshwayyat , Ken Uchino , Aaron M. Gusdon , Sung-Min Cho

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引用次数: 0

Abstract

Background

This study aimed to explore the risk of stroke death (SD) in cancer patients, estimate rates, and identify risk factors associated with SD.

Methods

In this retrospective study, we used the 17 National Cancer Institute Surveillance, Epidemiology, and End Results registries (2000–2020). A total of 5,922,533 patients diagnosed with their first primary cancer were included. The primary outcome was the standardized mortality ratio (SMR) of SD in cancer patients. Secondary outcomes included SD incidence rates and risk factors. Rates were calculated per 100,000 persons with the annual percentage change (APC).

Results

Among included patients, 56,686 (2.0 %) died due to stroke. Compared to the general population, younger patients (≤39 years) (SMR: 2.31) and patients receiving no treatment (SMR: 1.36) had the highest risk. Cancer types with the fastest-declining SD rates were in the male genital (APC: −13.9 %) and breast (APC: −11.8 %). Older age (hazard ratio [HR]: 1.11, p < 0.001), male sex (HR: 1.06, p < 0.001), and non-white race (HR: 1.13, p < 0.001) were associated with increased risk of SD. Cancers of the nervous system (HR: 3.42, p < 0.001), respiratory (HR: 1.38, p < 0.001), and head and neck (HR: 1.37, p < 0.001) had higher risk of SD vs. breast cancer. Patients with primary chemotherapy (HR: 0.69, p < 0.001) and radiotherapy (HR: 0.69, p < 0.001) demonstrated less risk vs. those without treatment.

Conclusion

SD has declined over the years for both sexes and all cancer types. Older age, non-white race, and certain cancers (nervous system, respiratory system, and head and neck) pose significant risks for SD.

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癌症患者中风死亡率的时间趋势和危险因素

背景本研究旨在探讨癌症患者中风死亡（SD）的风险、估计发病率并确定与 SD 相关的风险因素。方法在这项回顾性研究中，我们使用了美国国家癌症研究所的 17 个监测、流行病学和最终结果登记处（2000-2020 年）。共纳入了 5,922,533 名确诊为首发癌症的患者。主要结果是癌症患者的 SD 标准化死亡率 (SMR)。次要结果包括 SD 发病率和风险因素。结果在纳入的患者中，有56686人（2.0%）死于中风。与普通人群相比，年轻患者（≤39 岁）（SMR：2.31）和未接受治疗的患者（SMR：1.36）的风险最高。SD率下降最快的癌症类型是男性生殖器癌症（APC：-13.9%）和乳腺癌（APC：-11.8%）。高龄（危险比 [HR]：1.11，p < 0.001）、男性（HR：1.06，p < 0.001）和非白人种族（HR：1.13，p < 0.001）与自毁风险增加有关。与乳腺癌相比，神经系统癌症（HR：3.42，p <0.001）、呼吸系统癌症（HR：1.38，p <0.001）和头颈部癌症（HR：1.37，p <0.001）的 SD 风险更高。与未接受治疗的患者相比，接受初级化疗（HR：0.69，p <0.001）和放疗（HR：0.69，p <0.001）的患者发生 SD 的风险更低。高龄、非白种人和某些癌症（神经系统、呼吸系统和头颈部癌症）导致 SD 的风险显著增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.