Abstract TP295: Stroke Risk in Cancer Survivors: A Systematic Review and Meta-Analysis

Abstract

Background: It is suggested that survivors of different types of cancer may have an increased risk of stroke. Our study aims to evaluate cancer patients and non-cancer controls by analyzing stroke events in each group. Previous studies concluded that certain types of cancer increased stroke risk, however, their results had significant heterogeneity and statistical concerns. Methods: Medline, Embase, and Cochrane databases were systematically searched until February 18th, 2024, assessing stroke in cancer survivor patients compared to the global population. Data were examined using the Mantel-Haenszel method and 95% CIs. Heterogeneity was assessed using I 2 statistics. Review Manager 5.4 was used for statistical analysis. Results: A total of 18 studies were included, and stroke was reported in both cancer and non-cancer groups. Breast cancer (HR 1.09; 95% CI 1.02-1.17; p=0.01; I 2 = 0%), Central Nervous System cancers (HR 2.47; 95% CI 1.01-6.01; p=0.05; I 2 = 78%), cervical cancers (HR 1.58; 95% CI 1.19-2.09; p=0.001; I 2 = 0%), head and neck cancers (HR 1.34; 95% CI 1.07-1.68; p=0.01; I 2 = 59%), lung cancers (HR 1.60; 95% CI 1.40-1.83; p<0.00001; I 2 =67%), multiple myeloma (HR 1.58; 95% CI 1.32 -1.89; p<0.00001; I 2 = 49%), nasopharyngeal cancers (HR 1.72; 95% CI 1.28-2.30; p=0.0003; I 2 = 85%), oesophageal cancers (HR 1.33; 95% CI 1.07-1.65; p=0.009; I 2 = 0%), ovarian cancers (HR 1.33; 95% CI 1.07-1.65; p=0.01; I 2 = 38%), pancreatic cancers (HR 2,70; 95% CI 2.34-3.11; p<0.00001; I 2 = 0%) and rectum cancers (HR 1.29; 95% CI 1.01-1.63; p=0.04; I 2 = 0%) showed statistically significant differences between groups in favor of non-cancer controls. Conclusions: In this meta-analysis, the stroke risk was increased in all cancers that reached statistical significance. Furthermore, our study brings relevant data to the body of literature concerning this long-term clinical uncertainty.