Stroke as a cause of death in patients with cancer: a SEER-based study

Abstract

BackgroundDeath from stroke is linked to cancer due to its pathogenesis and side effects of treatment. Despite this, guidelines regarding identifying cancer patients at the highest risk of mortality from stroke are unclear. AimsTo determine which cancer subtypes are associated with higher risk of death from stroke. MethodsThe National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program was used to obtain data regarding patients with cancer who died of a stroke. We calculated standardized mortality ratios (SMRs) using SEER*Stat software, version 8.4.0.1. ResultsOut of 6,136,803 patients with cancer, 57,523 (0.9%) died from stroke, and this rate was higher than general population (SMR= 1.05, 95%CI [1.04-1.06]). Deaths due to stroke decreased across years, from 24,280 deaths between 2000-2004 to 4,903 deaths between 2015-2019. Of the 57,523 stroke deaths, greatest numbers were observed in cancers of the prostate (n=11,761, 20.4%), breast (n=8,946, 15.5%), colon and rectum (n=7,401, 12.8%), and lung and bronchus (n=4,376, 7.6%). Patients with colon and rectum cancers (SMR= 1.08 95%CI [1.06-1.11]), lung and bronchus cancers (SMR=1.70 95%CI [1.65-1.75]) had a greater rate of death from stroke compared to the general population. ConclusionThe risk of death from stroke in cancer patients is significantly higher than in the general population. Patients with colorectal cancer and lung and bronchus cancer are at higher risk of death by stroke compared to the general population.