Danish Cancer Society Research Center, Copenhagen, Denmark.
Department of Neurology, Bispebjerg University Hospital, Copenhagen, Denmark.
Acta Neurol Scand. 2020 Nov;142(5):486-492. doi: 10.1111/ane.13299. Epub 2020 Jul 13.
Stroke is associated with a higher risk of occult cancer. We studied the types of occult cancer most often associated with stroke.
All patients with incident stroke in Denmark 2003-2015 were identified through the Danish Stroke Registry (n = 85 893) and matched 1:10 on age and sex to the Danish background population without history of stroke (n = 858 740). Linking data to the Danish Cancer Registry, we determined the prevalence of occult cancer in stroke defined as the event of previously unknown cancer during a one-year follow-up in the stroke and the background population. We stratified cancers into the 15 most common cancers and into cancers related to and not related to smoking.
Prevalence (per 1000 person-years; stroke/background population) of smoking-related occult cancers (lung, colon, bladder rectum, pancreas, kidney, stomach, and head and neck) was 13.3/8.1 (P < .01) and of cancers not related to smoking (prostate, breast, melanoma, non-Hodgkin lymphoma, ovary, endometrial) it was 6.6/6.2 (P > .05). Among men with stroke prostate (5.8), lung (5.7), and colon cancers (2.9) were most frequent; among women, it was lung (4.7), breast(3.5), and colon cancer(2.8). Among men in the background population, prostate(5.4), lung (3.0), and colon cancers (2.1) were most frequent. Among women, it was breast (3.7), lung(2.1), and colon cancers (1.9).
Stroke patients' increased risk of occult cancer was predominantly for smoking-related cancers while there was no higher risk for the most frequent cancers unrelated to smoking, that is, prostate and breast cancers. Lung cancer is the dominant type of occult cancer in stroke.
中风与隐匿性癌症的风险增加相关。我们研究了与中风最常相关的隐匿性癌症类型。
通过丹麦中风登记处（n=85893）确定了 2003-2015 年丹麦所有新发中风患者，并按年龄和性别与无中风病史的丹麦背景人群（n=858740）1:10 匹配。通过与丹麦癌症登记处的数据链接，我们确定了在中风和背景人群中，在一年的随访中发现之前未知癌症的情况下，中风定义的隐匿性癌症的患病率。我们将癌症分为最常见的 15 种癌症和与吸烟相关及不相关的癌症。
（每 1000 人年；中风/背景人群）与吸烟相关的隐匿性癌症（肺、结肠、膀胱直肠、胰腺、肾、胃和头颈部）的患病率分别为 13.3/8.1（P<0.01），与吸烟无关的癌症（前列腺、乳房、黑色素瘤、非霍奇金淋巴瘤、卵巢、子宫内膜）为 6.6/6.2（P>.05）。在中风男性患者中，最常见的是前列腺癌（5.8）、肺癌（5.7）和结肠癌（2.9）；在女性中，最常见的是肺癌（4.7）、乳腺癌（3.5）和结肠癌（2.8）。在背景人群中的男性中，最常见的是前列腺癌（5.4）、肺癌（3.0）和结肠癌（2.1）。在女性中，最常见的是乳腺癌（3.7）、肺癌（2.1）和结肠癌（1.9）。
中风患者隐匿性癌症的风险增加主要与吸烟相关的癌症有关，而与非吸烟相关的最常见癌症（即前列腺癌和乳腺癌）没有更高的风险。肺癌是中风中隐匿性癌症的主要类型。
