https://orcid.org/0000-0003-1015-0021
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Abstract
Introduction
Cancer may increase the risk of bleeding. However, whether subdural hematoma is a marker of occult cancer remains unknown. We examined the association between non-traumatic subdural hematoma and cancer risk in a cohort study.
Materials and Methods
Using Danish nationwide health registries, we identified 2713 patients with non-traumatic subdural hematoma and no previous cancer diagnosis, who were hospitalized between April 1, 1996 and December 31, 2019. We computed age-, sex-, and calendar year-standardized incidence ratios (SIRs) as the ratio of the observed to expected number of patients with cancer by using national incidence rates as reference as a measure of relative risk.
Results
We identified 77 cancer cases within the first year of follow-up and 272 cancer cases thereafter. The one-year risk of cancer was 2.8% (95% confidence interval: 2.2–3.5), and the one-year SIR was 1.7 (95% confidence interval: 1.3–2.1). During the subsequent years, the SIR was 1.0 (95% confidence interval: 0.9–1.1). The relative risk was elevated for some hematological and liver cancers.
Conclusion
The risk of a new cancer diagnosis was clearly increased in patients with non-traumatic subdural hematoma compared with the general population during the first year of follow-up. However, the absolute risk was low, thus limiting the clinical relevance of pursuing early cancer detection in these patients.
Ethics Approval and Informed Consent
This study was conducted in accordance with the Declaration of Helsinki. The study was approved by the National Board of Health and by the Danish Data Protection Agency. According to Danish law, approval from the Danish Committee on Health Research Ethics was not necessary. Since this is a register-based study, written consent was not required.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
Professor Henrik Toft Sørensen reports The Department of Clinical Epidemiology, Aarhus University, receives funding for other studies from the European Medicines Agency and companies in the form of institutional research grants to (and administered by) Aarhus University. None of these studies have any relation to the present study. The authors state that they have no conflicts of interest. Results from this paper were presented at the International Conference on Thrombosis and Hemostasis Issues in Cancer (ICTHIC) in 2021 as a poster presentation. The related abstract was published in Thrombosis Research in April 2021:10.1016/S0049-3848(21)00272-3.