The Risk of Ischemic and Hemorrhagic Stroke in Head and Neck Cancer: A Longitudinal Cohort Study

Simple Summary Several previous studies have shown that head and neck cancer may be associated with an increased risk of ischemic stroke but not hemorrhagic stroke. However, whether head and neck cancer causes an increased risk of developing ischemic or hemorrhagic strokes remains unclear. We found that patients with head and neck cancer had a significantly increased risk of overall and ischemic stroke development, although there was no significant difference in the incidence and risk ratio of hemorrhagic stroke. However, in the subgroup analysis, patients with oral cavity cancer had a significantly increased risk of both ischemic and hemorrhagic strokes compared to the general population. These findings suggest that clinicians should carefully monitor the development of stroke when they follow head and neck cancer survivors. Several studies have shown that head and neck cancer is associated with an increased risk of stroke incidence. However, investigations of the association between the two diseases based on a matching cohort dataset are still limited. Therefore, we identified the incidence and risk of stroke in patients with head and neck cancer using a nationwide population-based cohort dataset. A total of 5248 individuals without cancer and 1312 with cancer were enrolled from the dataset after a 4:1 propensity score matching. We found that the incidence of overall stroke (per 1000 person years) was 19.29 for those with head and neck cancer, consisting of 17.32 as ischemic type and 2.74 as hemorrhagic type. Additionally, patients with head and neck cancer had a significantly increased risk of overall and ischemic stroke development but not hemorrhagic stroke. Moreover, the risk of stroke development over time was relatively high within the first year after the diagnosis of head and neck cancer. However, in the subgroup analysis, oral cavity cancer survivors showed an increased risk of both ischemic and hemorrhagic strokes. Therefore, our nationwide population-based cohort study suggests that clinicians should closely monitor patients with head and neck cancers for the early detection of stroke.