Key result
Syncope was associated with a twofold increased risk of being diagnosed with an occult cancer within 6 months (SIR 2.0), primarily driven by lung, colorectal, prostate, and brain cancers.
Why the study?
It was unknown whether syncope serves as a marker of occult cancer compared with cancer risk in the general population.
Does a syncope episode indicate an increased risk of occult cancer compared to the general population?
Cohort (n=208,361)
Does a syncope episode indicate an increased risk of occult cancer compared to the general population?
Effect estimate: SIR 2.0 (95% CI 1.8-2.0)
Syncope is a weak marker of occult cancer with a low absolute 6-month cumulative risk (1.2%), suggesting that aggressive cancer screening in syncope patients is not warranted.
Low absolute 6-month cancer risk after syncope (1.2%) does not support routine screening; leaves open targeted evaluation in observational data.
BACKGROUND: We examined if syncope was a marker of an occult cancer by comparing the risk in patients with a syncope episode with that of the general population. METHODS: Using Danish population-based medical registries, we identified all patients diagnosed with syncope during 1994-2013 and followed them until a cancer diagnosis, emigration, death or end of follow-up, whichever came first. We computed cumulative risks and standardised incidence ratios (SIR) with 95% confidence intervals (CI). RESULTS: Among 208,361 patients with syncope, 20,278 subsequent cancers were observed. The 6-month cumulative risk of any cancer was 1.2%, increasing to 17.9 % for 1-20 years of follow-up. The highest cumulative risks after 6 months of follow-up were lung cancer (0.2%), colorectal cancer (0.2%), prostate cancer (0.1%) and brain cancer (0.1%). The 6-month SIR were 2.7 (95% CI: 2.4-3.0) for lung cancer, 2.0 (95% CI: 1.8-2.2) for colorectal cancer, 1.7 (95% CI: 1.5-1.9) for prostate cancer and 10.0 (95% CI: 8.6-11.4) for brain cancer. CONCLUSIONS: Syncope was a weak marker of an occult cancer. In short-term the highest cumulative risks were observed for lung, colorectal, prostate and brain cancers. An aggressive search for occult cancer in a patient with syncope is probably not warranted.
No takes yet. Share an insight, caveat, or question.
Lorenzen et al. (2019) conducted a cohort in Syncope (n=208,361). Syncope vs. General population (expected incidence) was evaluated on Any cancer diagnosis within 6 months (SIR 2.0, 95% CI 1.8-2.0). Syncope was associated with a twofold increased risk of being diagnosed with an occult cancer within 6 months (SIR 2.0), primarily driven by lung, colorectal, prostate, and brain cancers.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: