Cohort study | Younger stroke survivors show elevated cancer risk for up to 8 years

Summary: In this cohort study, 390,398 patients aged 15 years or older in the Netherlands, without a history of cancer and with a first-ever ischemic stroke or intracerebral hemorrhage (ICH), were analyzed between January 1, 1998, and January 1, 2019. The primary outcome was the cumulative incidence of first-ever cancer after the index stroke, stratified by stroke subtype, age, and sex, compared with age-, sex-, and calendar year-matched peers from the general population.

The findings revealed that, in the first year after a stroke, patients aged 15 to 49 years had a 3- to 5-fold increased risk of cancer compared to individuals without a stroke. In contrast, the risk was only slightly elevated for patients aged 50 years or older. The cancer risk remained elevated for up to 8 years after an ischemic stroke and 6 years after an ICH in the younger age group, with the highest risks observed for lung cancer, gastrointestinal cancer, and hematologic cancer.

The findings may be confounded by shared risk factors, such as smoking. Alternatively, the increased cancer risk may have a causal mechanism between cancer and stroke, possibly related to the hypercoagulable state induced by cancer. However, the study design does not allow for conclusions about causal mechanisms, and the researchers called for further studies investigating the usefulness of cancer screening after a stroke.

Article: Association of Stroke at Young Age With New Cancer in the Years After Stroke Among Patients in the Netherlands – JAMA Network Open