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Open Access Research

Increased risk of ischemic stroke in cervical cancer patients: a nationwide population-based study

Shiang-Jiun Tsai1, Yung-Sung Huang27, Chien-Hsueh Tung37, Ching-Chih Lee47, Moon-Sing Lee17, Wen-Yen Chiou17, Hon-Yi Lin17, Feng-Chun Hsu1, Chih-Hsin Tsai5, Yu-Chieh Su67 and Shih-Kai Hung17*

Author Affiliations

1 Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, 2, Ming Sheng Road, Dalin, Chiayi, Taiwan

2 Department of Neurology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan

3 Department of Allergy, Immunology and Rheumatology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan

4 Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan

5 Department of Industrial Engineering and Management, National Yunlin University of Science & Technology, Yunlin, Taiwan

6 Department of Hematology Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan

7 School of Medicine, Tzu Chi University, Hualien, Taiwan

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Radiation Oncology 2013, 8:41  doi:10.1186/1748-717X-8-41

Published: 28 February 2013

Abstract

Background

Increased risk of ischemic stroke has been validated for several cancers, but limited study evaluated this risk in cervical cancer patients. Our study aimed to evaluate the risk of ischemic stroke in cervical cancer patients.

Methods

The study analyzed data from the 2003 to 2008 National Health Insurance Research Database (NHIRD) provided by the National Health Research Institutes in Taiwan. Totally, 893 cervical cancer patients after radiotherapy and 1786 appendectomy patients were eligible. The Kaplan-Meier method and the Cox proportional hazards model were used to assess the risk of ischemic stroke.

Results

The 5-year cumulative risk of ischemic stroke was significantly higher for the cervical cancer group than for the control group (7.8% vs 5.1%; p <0.005). The risk of stroke was higher in younger (age <51 years) than in older (age ≥51 years) cervical cancer patients (HR = 2.73, p = 0.04; HR = 1.37, p = 0.07) and in patients with more than two comorbid risk factors (5 years cumulative stroke rate of two comorbidities: 15% compared to no comorbidities: 4%).

Conclusions

These study demonstrated cervical cancer patients had a higher risk of ischemic stroke than the general population, especially in younger patients. Strategies to reduce this risk should be assessed.

Keywords:
Cervical cancer; Radiotherapy; Stroke