Incidence of stroke in the first year after diagnosis of cancer—A protocol for systematic review and meta-analysis

• Published in: PloS one Vol. 16; no. 9; p. e0256825
• Main Authors: Lun, Ronda, Roy, Danielle Carole, Ramsay, Tim, Siegal, Deborah, Shorr, Risa, Fergusson, Dean, Dowlatshahi, Dar
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.09.2021; Public Library of Science (PLoS)
• Subjects: Cancer; Complications and side effects; Data collection; Diagnosis; Epidemiology; Ethics; Health risks; Hemorrhage; Heterogeneity; Hospitals; Human subjects; Humans; Incidence; Ischemia; Medical diagnosis; Medicine; Medicine and Health Sciences; Melanoma; Meta-analysis; Meta-Analysis as Topic; Mortality; Neoplasms - complications; Neoplasms - diagnosis; Neoplasms - epidemiology; Observational studies; Patients; Prevention; Public health; Quality assessment; Research ethics; Risk; Risk Assessment - statistics & numerical data; Risk Factors; Scientific conferences; Scientific papers; Skin cancer; Stroke; Stroke (Disease); Stroke - epidemiology; Stroke - etiology; Stroke - prevention & control; Study Protocol; Systematic review; Systematic Reviews as Topic; Time Factors; Canada; Ottawa Ontario Canada
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0256825

There is an increased risk of stroke in patients with cancer-this risk is particularly heightened around the time of cancer diagnosis, although no studies have systematically quantified this risk in the literature. Patients newly diagnosed with cancer without prior stroke represent a highly susceptible population in whom there is a window of opportunity to study and implement primary prevention strategies. Therefore, the objective of this systematic review and meta-analysis is to identify the cumulative incidence of ischemic and hemorrhagic strokes during the first year after a diagnosis of cancer. MEDLINE, EMBASE, and PubMed will be searched with the assistance from a medical information specialist, from 1980 until present. Eligible studies will include observational studies that have enrolled adult patients newly diagnosed with cancer and report outcomes of stroke during the first year of cancer diagnosis. We will exclude all randomized and non-randomized interventional studies. Data on participant characteristics, study design, baseline characteristics, and outcome characteristics will be extracted. Study quality will be assessed using the Newcastle-Ottawa Scale for cohort studies, and heterogeneity will be assessed using the I2 statistic. Pooled cumulative incidence will be calculated for ischemic and hemorrhagic strokes separately using a random-effects model. No formal research ethics approval is necessary as primary data collection will not be done. We will disseminate our findings through scientific conference presentations, peer-reviewed publications, and social media/the press. The findings from this review will inform clinicians and patients regarding the risk of stroke in patients newly diagnosed with cancer by quantifying the cumulative incidence of each subtype of stroke during the first year after a diagnosis of cancer. This represents a window of opportunity to implement prevention strategies in a susceptible population. osf.io/ucwy9.