The Incidence of Ischemic Stroke in Cancer Patients in Thailand

Objective: Cancer and stroke are leading causes of morbidity and mortality in Thailand. The objectives of the present study were 1) to determine the incidence of ischemic stroke in cancer patients in Thailand, 2) to identify the cancer subtypes most associated with ischemic stroke, and 3) to compare the etiology of stroke in two groups of patients, those who had conventional risk factors for stroke and those without conventional risk factors or cryptogenic stroke. Materials and Methods: The present study was a retrospective descriptive study. The authors collected data on cancer patients hospitalized between 2008 and 2020 according to International Classification of Disease and Related Health Problem Tenth Revision (ICD-10) and identified the number of ischemic stroke patients and the cancer subtype for each patient. Risk factors for stroke were identified as conventional risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, smoking, and imaging evidence of atherosclerosis) and cryptogenic risk factors (none of the conventional risk factors). Results: Sixteen thousand six hundred forty-seven cancer patients were included in the present study and 85 of these patients were diagnosed with ischemic stroke. Therefore, the incidence of ischemic stroke in cancer patients was 0.51%. The cancer subtypes most often associated with ischemic stroke were thoracic as predominantly lung, lower gastrointestinal tract, and hepatobiliary cancer. Most patients (88.24%) had at least one conventional risk factor. Hypertension was the most common conventional risk factor. Cryptogenic stroke was found in 5.88% of the patients and 5.88% of the patients had insufficient data on risk factors. Conclusion: The incidence of ischemic stroke in Thai cancer patients is low. Lung cancer is the cancer type most associated with ischemic stroke. Most cancer patients with ischemic stroke had multiple vascular risk factors. Keywords: Stroke; Cancer; Incidence