---
title: "Increased 1-Year Risk of Ischemic Stroke After Invasive Cancer Diagnosis: Nationwide Cohort Study"
id: "pubmed-42706874"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42706874"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42706874/"
doi: "10.1002/cncr.70536"
published_at: "2026-09-15T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Increased 1-Year Risk of Ischemic Stroke After Invasive Cancer Diagnosis: Nationwide Cohort Study
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42706874
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42706874/)
- **DOI:** [10.1002/cncr.70536](https://doi.org/10.1002%2Fcncr.70536)
- **Published At:** 2026-09-15T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This nationwide retrospective cohort linked the Israel National Cancer and Stroke Registries to quantify the risk of **ischemic stroke** (IS) during the first year after a first invasive cancer diagnosis in residents aged 40 and older. - The cohort included 182,221 patients diagnosed with first invasive cancer between 2014 and 2021 and followed for first-ever IS within 1 year. - Overall the standardized incidence ratio (**SIR**) for IS within 1 year after cancer diagnosis was 1.8 (95% CI, 1.7–1.9), indicating an elevated risk compared with the general population. - Risk was highest in the early postdiagnosis period, peaking during the first 3 months (SIR, 2.5; 95% CI, 2.2–2.7). - Cancer-site differences were large: pancreatic cancer had the highest SIR (5.9; 95% CI, 4.8–7.3), followed by lung cancer (SIR, 3.9; 95% CI, 3.4–4.4). - SIRs declined with age: 3.6 (95% CI, 2.8–4.6) for ages 40–54 versus 1.4 (95% CI, 1.3–1.6) for those ≥75 years. - Stroke risk increased with cancer stage, from SIR 1.2 (95% CI, 1.0–1.4) in localized disease to 2.8 (95% CI, 2.5–3.2) in metastatic disease. - One-year cumulative incidence of IS for the cohort was 0.62%; by site it ranged from 0.30% for breast cancer to 1.62% for pancreatic cancer. - The authors conclude the early period after cancer diagnosis is a critical window of increased **cerebrovascular** risk and recommend integrating targeted cerebrovascular risk assessment into oncologic care to identify high-risk subgroups and guide prevention strategies. - Conflict of interest: one author reported consulting fees to device companies; other authors declared no conflicts. - Additional methodological and limitation details beyond the abstract (for example, covariates, statistical modeling specifics, and granular subgroup counts) were not reported in the source excerpt provided.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 School of Public Health, University of Haifa, Haifa, Israel. * 2 Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel. * 3 Rambam Health Care Campus, Haifa, Israel. * 4 Technion Faculty of Medicine, Haifa, Israel. * PMID: **42706874** * PMCID: [ PMC13551048 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13551048/) * DOI: [ 10.1002/cncr.70536 ](https://doi.org/10.1002/cncr.70536) Item in Clipboard # Elevated risk of ischemic stroke after invasive cancer diagnosis: A nationwide population-based study Carmit Libruder et al. Cancer. 2026. Show details Display options Display options Format Abstract PubMed PMID Cancer Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cancer%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Cancer%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42706874/) . 2026 Sep 15;132(18):e70536. doi: 10.1002/cncr.70536. ### Authors [Carmit Libruder](https://pubmed.ncbi.nlm.nih.gov/?term=Libruder+C&cauthor_id=42706874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42706874/#short-view-affiliation-1 "School of Public Health, University of Haifa, Haifa, Israel.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42706874/#short-view-affiliation-2 "Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel."), [David Tanne](https://pubmed.ncbi.nlm.nih.gov/?term=Tanne+D&cauthor_id=42706874)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42706874/#short-view-affiliation-3 "Rambam Health Care Campus, Haifa, Israel.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42706874/#short-view-affiliation-4 "Technion Faculty of Medicine, Haifa, Israel."), [Barbara G Silverman](https://pubmed.ncbi.nlm.nih.gov/?term=Silverman+BG&cauthor_id=42706874)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42706874/#short-view-affiliation-2 "Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel."), [Binyamin Binyaminy](https://pubmed.ncbi.nlm.nih.gov/?term=Binyaminy+B&cauthor_id=42706874)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42706874/#short-view-affiliation-2 "Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel."), [Rita Dichtiar](https://pubmed.ncbi.nlm.nih.gov/?term=Dichtiar+R&cauthor_id=42706874)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42706874/#short-view-affiliation-2 "Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel."), [Lital Keinan-Boker](https://pubmed.ncbi.nlm.nih.gov/?term=Keinan-Boker+L&cauthor_id=42706874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42706874/#short-view-affiliation-1 "School of Public Health, University of Haifa, Haifa, Israel.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42706874/#short-view-affiliation-2 "Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel.") ### Affiliations * 1 School of Public Health, University of Haifa, Haifa, Israel. * 2 Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel. * 3 Rambam Health Care Campus, Haifa, Israel. * 4 Technion Faculty of Medicine, Haifa, Israel. * PMID: **42706874** * PMCID: [ PMC13551048 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13551048/) * DOI: [ 10.1002/cncr.70536 ](https://doi.org/10.1002/cncr.70536) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Cancer and stroke are major causes of morbidity and mortality, with an increasing shared burden. This study aimed to provide population-based estimates of ischemic stroke (IS) risk after cancer diagnosis across multiple cancer sites and demographic subgroups. **Methods:** A retrospective cohort study was conducted linking the Israel National Cancer and Stroke Registries. Residents ≥40 years old diagnosed with first invasive cancer during 2014-2021 were followed for first-ever IS within 1 year. IS risk was assessed using standardized incidence ratios (SIRs) and analyzed by cancer site, time since diagnosis, cancer stage, and demographic subgroups. One-year cumulative incidence was estimated with death as a competing event. **Results:** Among 182,221 patients, the SIR for IS within 1 year after cancer diagnosis was 1.8 (95% confidence interval [CI], 1.7-1.9). Risk peaked during the first 3 months (SIR, 2.5; 95% CI, 2.2-2.7). The highest SIRs were observed for pancreatic (SIR, 5.9; 95% CI, 4.8-7.3) and lung (SIR, 3.9; 95% CI, 3.4-4.4) cancers. SIRs decreased with age from 3.6 (95% CI, 2.8-4.6) among adults 40-54 years old to 1.4 (95% CI, 1.3-1.6) among those ≥75 years old. SIRs increased with stage, from 1.2 (95% CI, 1.0-1.4) in localized disease to 2.8 (95% CI, 2.5-3.2) in metastatic disease. One-year cumulative incidence of IS was 0.62%, ranging from 0.30% in breast cancer to 1.62% in pancreatic cancer. **Conclusions:** The early period after cancer diagnosis represents a critical window of increased IS risk. Incorporating targeted cerebrovascular risk assessment into oncologic care may facilitate earlier identification of high-risk subgroups and support tailored prevention strategies. **Keywords:** cancer; cancer‐associated stroke; cerebrovascular disease; cohort study; ischemic stroke; population‐based study. © 2026 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement David Tanne reports consulting fees from Perflow Medical, Pi‐Cardia, and QuantalX Neuroscience. The other authors declare no conflicts of interest. ## Figures [ ![FIGURE 1](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16e9/13551048/d5c1130d232d/CNCR-132-e70536-g003.gif) ](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16e9/13551048/e7509ffdf608/CNCR-132-e70536-g003.webp) ** FIGURE 1 ** Flowchart illustrating the cancer cohort… ** FIGURE 1 ** Flowchart illustrating the cancer cohort selection. **FIGURE 1** Flowchart illustrating the cancer cohort selection. [ ![FIGURE 2](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16e9/13551048/a77db9451693/CNCR-132-e70536-g001.gif) ](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16e9/13551048/a256aaa1608c/CNCR-132-e70536-g001.webp) ** FIGURE 2 ** SIRs for first‐ever ischemic stroke… ** FIGURE 2 ** SIRs for first‐ever ischemic stroke after cancer diagnosis, by time since diagnosis. SIRs… **FIGURE 2** SIRs for first‐ever ischemic stroke after cancer diagnosis, by time since diagnosis. SIRs are shown for all cancers combined and for selected cancer sites, standardized by age, sex, and population group. Error bars indicate 95% confidence intervals. The dashed vertical line indicates SIR = 1. SIR indicates standardized incidence ratio. [ ![FIGURE 3](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16e9/13551048/90c3ddd42433/CNCR-132-e70536-g002.gif) ](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16e9/13551048/a0b286b36e70/CNCR-132-e70536-g002.webp) ** FIGURE 3 ** SIRs for first‐ever ischemic stroke… ** FIGURE 3 ** SIRs for first‐ever ischemic stroke within 1 year after cancer diagnosis. (A) SIRs… **FIGURE 3** SIRs for first‐ever ischemic stroke within 1 year after cancer diagnosis. (A) SIRs by age group, standardized by sex and population group. (B) SIRs by cancer stage, standardized by age, sex, and population group. Error bars indicate 95% confidence intervals. The dashed vertical line indicates SIR = 1. Unknown stage is indicated by an open circle with dashed confidence intervals. SIR indicates standardized incidence ratio. [ ![FIGURE 4](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16e9/13551048/8f886f35f562/CNCR-132-e70536-g004.gif) ](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16e9/13551048/2386119de81b/CNCR-132-e70536-g004.webp) ** FIGURE 4 ** One‐year cumulative incidences of ischemic… ** FIGURE 4 ** One‐year cumulative incidences of ischemic stroke and death after cancer diagnosis. (A) Cumulative… **FIGURE 4** One‐year cumulative incidences of ischemic stroke and death after cancer diagnosis. (A) Cumulative incidence of first‐ever ischemic stroke, with death as a competing event. The dashed curve shows the expected cumulative incidence based on general population rates. (B) Cumulative incidence of death, with ischemic stroke as a competing event. Curves for all cancers combined and for selected cancer sites are shown in both panels. The vertical dashed line indicates 3 months after cancer diagnosis. [See this image and copyright information in PMC](https://pubmed.ncbi.nlm.nih.gov/42706874/) ## Similar articles * [ Diagnosis of hyponatremia and increased risk of a subsequent cancer diagnosis: results from a nationwide population-based cohort study. ](https://pubmed.ncbi.nlm.nih.gov/28920509/) Holland-Bill L, Christiansen CF, Farkas DK, Donskov F, Jørgensen JOL, Sørensen HT.Holland-Bill L, et al.Acta Oncol. 2018 Apr;57(4):522-527. doi: 10.1080/0284186X.2017.1378430. 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