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. 2022 Sep 20:13:966190.
doi: 10.3389/fneur.2022.966190. eCollection 2022.

Incidence of stroke in the first year after diagnosis of cancer-A systematic review and meta-analysis

Ronda Lun  1   2   3 , Danielle Carole Roy  2 , Yu Hao  4 , Rishi Deka  5   6   7 , Wen-Kuan Huang  8 , Babak B Navi  9   10 , Deborah M Siegal  3   11 , Tim Ramsay  2   3 , Dean Fergusson  2   3 , Risa Shorr  12 , Dar Dowlatshahi  1   2   3
Affiliations

Incidence of stroke in the first year after diagnosis of cancer-A systematic review and meta-analysis

Ronda Lun et al. Front Neurol. .

Abstract

Background: Patients newly diagnosed with cancer represent a population at highest risk for stroke. The objective of this systematic review and meta-analysis was to estimate the incidence of stroke in the first year following a new diagnosis of cancer.

Methods: We searched MEDLINE and EMBASE from January 1980 to June 2021 for observational studies that enrolled adults with a new diagnosis of all cancers excluding non-melanoma skin cancer, and that reported the incidence of stroke at 1 year. PRISMA guidelines for meta-analyses were followed. Two reviewers independently extracted data and appraised risk of bias. We used the Dersimonian and Laird random effects method to pool cumulative incidences after logit transformation, and reported pooled proportions as percentages. Statistical heterogeneity was assessed using the I 2 statistic.

Results: A total of 12,083 studies were screened; 41 studies were included for analysis. Data from 2,552,121 subjects with cancer were analyzed. The cumulative incidence of total stroke at 1 year was 1.4% (95% CI 0.9-2.2%), while the pooled incidence of ischemic stroke was 1.3% (95% CI 1.0-1.8%) and 0.3% (95% CI 0.1-0.9%) for spontaneous intracerebral hemorrhage (ICH), with consistently high statistical heterogeneity (>99% I 2).

Conclusion: The estimated incidence of stroke during the first year after a new diagnosis of cancer is 1.4%, with a higher risk for ischemic stroke than ICH. Cancer patients should be educated on the risk of stroke at the time of diagnosis. Future studies should evaluate optimal primary prevention strategies in this high-risk group of patients.

Systematic review registration: https://osf.io/ucwy9/.

Keywords: cancer; epidemiology; incidence; meta-analysis; population health; risk; stroke; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer Y-CW declared a shared affiliation with the author W-KH to the handling editor at the time of review.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Forest plot of the pooled incidence of total stroke (ischemic and hemorrhagic) at 1 year after a diagnosis of cancer.
Figure 3
Figure 3
Forest plot of the pooled incidence of ischemic stroke at 1 year after a diagnosis of cancer.
Figure 4
Figure 4
Forest plot of the pooled incidence of spontaneous ICH at 1 year after a diagnosis of cancer.
See this image and copyright information in PMC

References

    1. Lun R, Roy DC, Ramsay T, Siegal D, Shorr R, Fergusson D, et al. Incidence of stroke in the first year after diagnosis of cancer-a protocol for systematic review and meta-analysis. PLoS ONE. (2021) 16:e0256825. 10.1371/journal.pone.0256825 - DOI - PMC - PubMed
    1. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA. Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane (2020). Available online at: www.training.cochrane.org/handbook
    1. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. (2021) 372:n71. 10.1136/bmj.n71 - DOI - PMC - PubMed
    1. Shi X, Chen Q, Wang F. Mesenchymal stem cells for the treatment of ulcerative colitis: a systematic review and meta-analysis of experimental and clinical studies. Stem Cell Res Ther. (2019) 10:266. 10.1186/s13287-019-1336-4 - DOI - PMC - PubMed
    1. Huang C, Lin X, He J, Liu N. Enrichment and detection method for the prognostic value of circulating tumor cells in ovarian cancer: a meta-analysis. Gynecol Oncol. (2021) 161:613–20. 10.1016/j.ygyno.2021.02.024 - DOI - PubMed

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