Association between Incident Cancer and Subsequent Stroke
Running head: Stroke Risk in Cancer Patients
Babak B. Navi, MD1,2,3; Anne S. Reiner, MPH4; Hooman Kamel, MD1,2; Costantino Iadecola, MD1,2; Mitchell S.V. Elkind, MD, MS5,6; Katherine S. Panageas, DrPH4; Lisa M. DeAngelis, MD1,3
1
Department of Neurology and 2Brain and Mind Research Institute, Weill Cornell Medical
College, New York, NY; 3Department of Neurology and 4Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY; 5Department of Neurology, Columbia College of Physicians and Surgeons, New York, NY; and 6Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
Correspondence to: Babak B. Navi, MD 525 East 68th Street, Room F610 New York, NY 10065 Phone: 212-746-0225; Fax: 212-746-5509 Email: [email protected]
Title character count: 57; Running head character count: 40; Abstract word count: 250; Manuscript word count: 2925; Number of figures: 1; Number of tables: 5. This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as an ‘Accepted Article’, doi: 10.1002/ana.24325 This article is protected by copyright. All rights reserved.
Annals of Neurology
Objective: To examine the association between incident cancer and the subsequent risk of stroke. Methods: Using the Surveillance Epidemiology and End Results-Medicare linked database, we identified patients with a new primary diagnosis of breast, colorectal, lung, pancreatic, or prostate cancer from 2001 through 2007. These patients were individually matched by age, sex, race, registry, and medical comorbidities to a group of Medicare enrollees without cancer, and each pair was followed through 2009. Validated diagnosis codes were used to identify a primary outcome of stroke. Cumulative incidence rates were calculated using competing risk survival statistics. Results: Among 327,389 pairs of cancer patients and matched controls, the 3-month cumulative incidence of stroke was generally higher in patients with cancer. Cumulative incidence rates were 5.1% (95% confidence interval [CI], 4.9-5.2%) in patients with lung cancer compared to 1.2% (95% CI, 1.2-1.3%) in controls (p
Running head: Stroke Risk in Cancer Patients
Babak B. Navi, MD1,2,3; Anne S. Reiner, MPH4; Hooman Kamel, MD1,2; Costantino Iadecola, MD1,2; Mitchell S.V. Elkind, MD, MS5,6; Katherine S. Panageas, DrPH4; Lisa M. DeAngelis, MD1,3
1
Department of Neurology and 2Brain and Mind Research Institute, Weill Cornell Medical
College, New York, NY; 3Department of Neurology and 4Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY; 5Department of Neurology, Columbia College of Physicians and Surgeons, New York, NY; and 6Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
Correspondence to: Babak B. Navi, MD 525 East 68th Street, Room F610 New York, NY 10065 Phone: 212-746-0225; Fax: 212-746-5509 Email: [email protected]
Title character count: 57; Running head character count: 40; Abstract word count: 250; Manuscript word count: 2925; Number of figures: 1; Number of tables: 5. This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as an ‘Accepted Article’, doi: 10.1002/ana.24325 This article is protected by copyright. All rights reserved.
Annals of Neurology
Objective: To examine the association between incident cancer and the subsequent risk of stroke. Methods: Using the Surveillance Epidemiology and End Results-Medicare linked database, we identified patients with a new primary diagnosis of breast, colorectal, lung, pancreatic, or prostate cancer from 2001 through 2007. These patients were individually matched by age, sex, race, registry, and medical comorbidities to a group of Medicare enrollees without cancer, and each pair was followed through 2009. Validated diagnosis codes were used to identify a primary outcome of stroke. Cumulative incidence rates were calculated using competing risk survival statistics. Results: Among 327,389 pairs of cancer patients and matched controls, the 3-month cumulative incidence of stroke was generally higher in patients with cancer. Cumulative incidence rates were 5.1% (95% confidence interval [CI], 4.9-5.2%) in patients with lung cancer compared to 1.2% (95% CI, 1.2-1.3%) in controls (p
