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The Long-Term Effect of Cancer on Incident Stroke: A Nationwide Population-Based Cohort Study in Korea

Background and Purpose: Despite the recent growing interest in the cancer–stroke association, the long-term effect, and organ-specific association with stroke incidence in subjects with cancer have not been clearly defined. Methods: Data were obtained from the Korean National Health Insurance Servic...

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Autores principales: Jang, Hyun-Soon, Choi, Jimi, Shin, Jaewon, Chung, Jong-Won, Bang, Oh Young, Kim, Gyeong-Moon, Seo, Woo-Keun, Lee, Juneyoung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370617/
https://www.ncbi.nlm.nih.gov/pubmed/30804874
http://dx.doi.org/10.3389/fneur.2019.00052
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author Jang, Hyun-Soon
Choi, Jimi
Shin, Jaewon
Chung, Jong-Won
Bang, Oh Young
Kim, Gyeong-Moon
Seo, Woo-Keun
Lee, Juneyoung
author_facet Jang, Hyun-Soon
Choi, Jimi
Shin, Jaewon
Chung, Jong-Won
Bang, Oh Young
Kim, Gyeong-Moon
Seo, Woo-Keun
Lee, Juneyoung
author_sort Jang, Hyun-Soon
collection PubMed
description Background and Purpose: Despite the recent growing interest in the cancer–stroke association, the long-term effect, and organ-specific association with stroke incidence in subjects with cancer have not been clearly defined. Methods: Data were obtained from the Korean National Health Insurance Service National Sample Cohort database between 2002 and 2015. To investigate the effects of cancer on stroke incidence, subjects were classified into cancer and non-cancer groups based on the period after cancer diagnosis and origin organ of cancer. To minimize the effects of selection bias, we performed a propensity score matching analysis with covariates of demographic data, vascular risk factors, antithrombotics use and statin use. Incident stroke was diagnosed based on operational definition and classified into ischemic stroke and hemorrhagic stroke. Results: Data of 20,707 subjects with cancer and 675,594 without cancer were analyzed for 7 follow-up years. The subjects with cancer had higher risk of any stroke (subdistribution hazard ratio [SHR], 1.13; 95% confidence interval [CI], 1.02–1.26; p = 0.0181) than those without cancer. Similar trend was found for ischemic stroke (SHR, 1.17; 95% CI, 1.05–1.31; p = 0.0054), but not for hemorrhagic stroke. The risk of stroke was increased in subjects with cancer in the digestive organ, respiratory and intrathoracic organ, and “others (such as breast and female and male reproductive organs)” in 3 years; however, the association disappeared thereafter except those with “others” cancer. Chemotherapy increased the risk of ischemic stroke (SHR 1.21; 95% CI, 1.03–1.41). Conclusions: Cancer increases the risk of stroke at 3 years after the diagnosis of cancer, and the effect was maintained for 7 years. The association between cancer and stroke incidence depends on the organ from which the cancer originated and chemotherapy.
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spelling pubmed-63706172019-02-25 The Long-Term Effect of Cancer on Incident Stroke: A Nationwide Population-Based Cohort Study in Korea Jang, Hyun-Soon Choi, Jimi Shin, Jaewon Chung, Jong-Won Bang, Oh Young Kim, Gyeong-Moon Seo, Woo-Keun Lee, Juneyoung Front Neurol Neurology Background and Purpose: Despite the recent growing interest in the cancer–stroke association, the long-term effect, and organ-specific association with stroke incidence in subjects with cancer have not been clearly defined. Methods: Data were obtained from the Korean National Health Insurance Service National Sample Cohort database between 2002 and 2015. To investigate the effects of cancer on stroke incidence, subjects were classified into cancer and non-cancer groups based on the period after cancer diagnosis and origin organ of cancer. To minimize the effects of selection bias, we performed a propensity score matching analysis with covariates of demographic data, vascular risk factors, antithrombotics use and statin use. Incident stroke was diagnosed based on operational definition and classified into ischemic stroke and hemorrhagic stroke. Results: Data of 20,707 subjects with cancer and 675,594 without cancer were analyzed for 7 follow-up years. The subjects with cancer had higher risk of any stroke (subdistribution hazard ratio [SHR], 1.13; 95% confidence interval [CI], 1.02–1.26; p = 0.0181) than those without cancer. Similar trend was found for ischemic stroke (SHR, 1.17; 95% CI, 1.05–1.31; p = 0.0054), but not for hemorrhagic stroke. The risk of stroke was increased in subjects with cancer in the digestive organ, respiratory and intrathoracic organ, and “others (such as breast and female and male reproductive organs)” in 3 years; however, the association disappeared thereafter except those with “others” cancer. Chemotherapy increased the risk of ischemic stroke (SHR 1.21; 95% CI, 1.03–1.41). Conclusions: Cancer increases the risk of stroke at 3 years after the diagnosis of cancer, and the effect was maintained for 7 years. The association between cancer and stroke incidence depends on the organ from which the cancer originated and chemotherapy. Frontiers Media S.A. 2019-02-05 /pmc/articles/PMC6370617/ /pubmed/30804874 http://dx.doi.org/10.3389/fneur.2019.00052 Text en Copyright © 2019 Jang, Choi, Shin, Chung, Bang, Kim, Seo and Lee. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Jang, Hyun-Soon
Choi, Jimi
Shin, Jaewon
Chung, Jong-Won
Bang, Oh Young
Kim, Gyeong-Moon
Seo, Woo-Keun
Lee, Juneyoung
The Long-Term Effect of Cancer on Incident Stroke: A Nationwide Population-Based Cohort Study in Korea
title The Long-Term Effect of Cancer on Incident Stroke: A Nationwide Population-Based Cohort Study in Korea
title_full The Long-Term Effect of Cancer on Incident Stroke: A Nationwide Population-Based Cohort Study in Korea
title_fullStr The Long-Term Effect of Cancer on Incident Stroke: A Nationwide Population-Based Cohort Study in Korea
title_full_unstemmed The Long-Term Effect of Cancer on Incident Stroke: A Nationwide Population-Based Cohort Study in Korea
title_short The Long-Term Effect of Cancer on Incident Stroke: A Nationwide Population-Based Cohort Study in Korea
title_sort long-term effect of cancer on incident stroke: a nationwide population-based cohort study in korea
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370617/
https://www.ncbi.nlm.nih.gov/pubmed/30804874
http://dx.doi.org/10.3389/fneur.2019.00052
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