Cancer And Stroke - An Irish Centre’s Experience Of Emerging Trends Of Co-Diagnosis

Abstract

Abstract Background Cancer is an increasingly recognised independent risk factor for the development of stroke, with emerging evidence of stroke, in the context of malignancy being its own pathophysiological subtype (Sonbol et al., 2023). Both cancer and stroke risk are associated with increasing age, with stroke mortality in cancer patients significantly higher (Sanossian et al., 2012). Due to the increasingly ageing population in Ireland, the number of those presenting with dual diagnosis is set to increase. We sought to review numbers presenting with stroke and cancer to our stroke service. Methods Patients admitted with confirmed stroke diagnosis were identified through Hospital Inpatient Enquiry (HIPE) data from March 2023 to May 2024. This cohort was then screened for a co-existing oncological diagnosis. The following variables were collected: recency of cancer diagnosis, subtype of stroke, anti-cancer therapy treatment to date, risk factors for developing cardiovascular disease using atherosclerosis cardiovascular disease score (ASCVD) and baseline CRP on admission. Results 71/320 (22%) patients admitted to our service in the defined period were identified as having a co-diagnosis of stroke and cancer (new or historical). Of those 71 patents, 8(11%) had a new or recent (<1 year) cancer diagnosis at stroke presentation and 63 were found to have a historical diagnosis (>1year). Prostate cancer represented the largest proportion of patients followed by lung and skin. 11(15%) were actively on cancer treatment at time of presentation of stroke. For patients actively on treatment, 5/11 had received platinum-based therapies. Average ASCVD risk factor score was 29.7%. Conclusion One in five patients with acute stroke had new or historical diagnosis of cancer in our cohort. A national prospective registry of patients with cancer and stroke could be useful in understanding patterns of stroke in cancer and help plan services and treatments for this specific population.