Nasopharyngeal Carcinoma related to increased Stroke risk in survivors, Study finds

In a new study conducted by Teng Hwee Tan and team it was found that in comparison to the general population, survivors of nasopharyngeal carcinoma (NPC), particularly those with stage 1 illness, had a significantly higher risk of stroke. NPC survivors did not have a substantially greater chance of dying within 30 days of a stroke.

The findings of the study were published in the journal of Neurology.

The goal of this study was to investigate the risk of stroke and mortality in NPC survivors within 30 days following a stroke. From January 1, 2005, to December 31, 2017, researchers conducted a population-based cohort study of individuals diagnosed with NPC. They report the age-standardized incidence rate differences (SIRDs) ratios (SIRs) and the cumulative incidence of stroke, as well as the standardized mortality rate differences (SMRDs) and ratios (SMRs) for all causes of death within 30 days after stroke for NPC survivors, using cancer and stroke disease registries as the reference population.

The results of this study stated as follow:

1. 96 people suffered stroke over a median follow-up of 48.4 months (interquartile range 19.8–92.9 months) for 3,849 patients diagnosed with NPC.

2. Overall, the stroke SIRD and SIR were 3.12 and 2.54, respectively.

3. The SIR was highest for the age group 30 to 39 years old (16.41, 95% CI 6.01–35.82), whereas the SIRD was highest for the age group 70 to 79 years old (8.84 instances per 1,000 person-years, 95% CI 0.46–17.21).

4. For stage 1 disease, the SIRD and SIR were (6.96 cases per 1000 person-years, 95% confidence interval 2.16–11.77) and (4.15, 95% confidence interval 2.46–7.00), respectively.

5. For all-cause fatalities within 30 days after stroke, the SMRD and SMR were (3.20 instances per 100 people, 95% CI 3.87–10.28) and (1.34, 95% CI 0.76–2.37), respectively.

In conclusion, the findings show that NPC survivors have a higher risk of stroke. This is especially true in stage I illness (as opposed to later stages), which is a bit perplexing and difficult to explain. Among addition, this provides Class II evidence of a higher risk of stroke in NPC survivors than in the general population.

Reference:

Tan TH, Zheng H, Cheo T, Tey J, Soon YY. Risk of Stroke in Nasopharyngeal Cancer Survivors: A National Registry-Based Population Cohort Study. Neurology. 2021 Nov 12:10.1212/WNL.0000000000013058. doi:10.1212/WNL.0000000000013058.