Epidemiology of Cancer-Associated Thrombosis in Asia: A Systematic Review

Abstract

The epidemiology of cancer associated thrombosis (CAT) in Asia is less well-studied and differs from that in the western countries. Here, we systematically examine population based and hospital-based studies reported between 1995 and 2020 to understand the epidemiology of CAT in Asia. From population-based studies, the estimated incidence of VTE in cancer patients was 1.85–9.88 per 1,000 person-years. The incidence of CAT in Asia is significantly higher than non-cancer associated VTE in the general population and cancer is perhaps the most important risk factor for VTE. Hospital-based studies were heterogeneous in study designs and reveal a wide range of prevalence of VTE among cancer patients at 0.5–44.6% while the cancer prevalence rates among VTE patients ranged from 6.1 to 65.5%. The cancer sites most associated with VTE and risk factors were similar between Asian and Western studies. CAT has a major impact on the survival of patients with cancer in Asia, but thromboprophylaxis is not commonly practiced and validated risk assessment tools are lacking. This study highlights the urgent need for large multinational epidemiological studies in Asia to establish the true burden of CAT and to guide appropriate prevention strategies.

Emergency department cardiovascular disease encounters and associated mortality in patients with cancer: a study of 20.6 million records from the USA

“…Cancer patients have been shown to have a 5-7 fold increase of developing VTE [26,27], and for those patients who develop VTE with cancer, they have a significantly worse prognosis compared to cancer patients without VTE [28]. In our analysis, DVT/PE was more common in those with colorectal (28.1%), breast (22.7%), and lung cancer (21.9%); these findings are consistent with previous reports [23,29]. The augmented risk of VTE in patients with these cancers is likely complicated with requirement for major surgeries, which as well as further increasing the risk of VTE may also be associated with interruptions to anticoagulation.…”

Association between Hyperosmolar Hyperglycemic State and Venous Thromboembolism in Diabetes Patients: A Nationwide Analysis in Taiwan

“…Prophylactic anticoagulation was suggested for HHS hospitalization in Western countries, where the benefit and bleeding risk may not be the same as those found in Asia. Although some conditions (such as malignancy, pneumonia, and heart failure) are considered risk factors for VTE, prophylactic anticoagulants are not routinely prescribed in Taiwan [39][40][41][42]. Our study further supported that, unlike in Western populations, prophylactic anticoagulants seem unnecessary for patients with HHS in Taiwan.…”

Incidence and risk factors for venous thromboembolism, bleeding, and death in colorectal cancer (Cancer‐VTE Registry)

“…Venous thromboembolism is known to increase mortality in patients with cancer 35 and, in this study, a 3.7‐fold increased risk of all‐cause death was observed in patients with baseline VTE versus those without baseline VTE. This is consistent with previous studies that report VTE to be a risk factor for mortality in a range of patients of different ethnicities with colorectal cancer 42–46 .…”