Incidence of venous thrombosis in a large cohort of 66 329 cancer patients: results of a record linkage study

Abstract

See also H. T. Sørensen. Cancer and subsequent risk of venous thromboembolism. This issue, pp 527-8. Summary. Background: The incidence of venous thrombosis (VT) for cancer patients is increased compared with patients without cancer, but estimations of the incidence for different types of cancer have rarely been made because of the low incidence of various types of cancer. Large registries offer an opportunity to study the risk of VT in large cohorts of cancer patients, which is essential in decisions on prophylactic anti-coagulant treatment. Methods: This cohort study estimates the incidence of VT in cancer patients by using record linkage of a Cancer Registry and an Anticoagulation Clinic database in the Netherlands. Cumulative incidences in patients with different types of malignancies were estimated. We calculated relative risks (RRs) in relation to the presence of distant metastases and treatment. Results: Tumors of the bone, ovary, brain, and pancreas are associated with the highest incidence of VT (37.7, 32.6, 32.1, and 22.7/1000/0.5 year). Patients with distant metastases had a 1.9-fold increased risk [RR adj : 1.9; 95% confidence interval (CI): 1.6-2.3]. Chemotherapy leads to a 2.2-fold increased risk (RR adj : 2.2; 95% CI: 1.8-2.7) and hormonal therapy leads to a 1.6-fold increased risk (RR adj : 1.6; 95% CI: 1.3-2.1) compared with patients not using these treatment modalities. Patients with radiotherapy or surgery did not have an increased risk. Conclusions: We compared the overall incidences of VT in the first half year in our study to the risk of major bleeding as described in the literature. For patients with distant metastases, for several types of cancer, prophylactic anti-thrombotic treatment could be beneficial.

Early Venous Thromboembolic Events Are Associated With Worse Prognosis in Patients With Lung Cancer

“…Chemotherapy is also considered an additional risk factor for VTE in cancer patients [20,25,26] and higher incidence of VTE early after initiation of chemotherapy has been demonstrated in the past [17], Here, we demonstrate that EVTE is predictive for worse outcomes irrespective of chemotherapy administration. Finally, patients with symptomatic VTE had similar outcomes compared to those with incidentally discovered, asymptomatic VTE, which is consistent with what has been reported so far [27].…”

When are breast cancer patients at highest risk of venous thromboembolism? A cohort study using English health care data

“…Previous cohort studies have identified several risk factors for VTE in breast cancer patients including metastatic disease, 2,7,8 chemotherapy, 2,8,9 and tamoxifen treatment. 10 A recent systematic review demonstrated that on average, breast cancer patients selected because they had either metastatic disease or were undergoing surgery or chemotherapy had a 10-fold increase in VTE risk compared with the breast cancer population as a whole.…”

Microparticle‐associated tissue factor activity: a link between cancer and thrombosis?

“…The incidence of thrombosis is high in adenocarcinomas such as ovarian, prostate and gastro-intestinal carcinoma [2,3], but is particularly high (up to 57%) in patients with pancreatic cancer [4][5][6]. However, the cause of this association is still unknown.…”