Prevalence of Cancer in Patients with Venous Thromboembolism: A Retrospective Nationwide Case-Control Study in Sweden

Abstract

Cancer is a risk factor for venous thromboembolism (VTE). We aimed to define sex-specific risk of preceding cancer in patients with a first-time VTE by conducting a nationwide Swedish registry-based study including 298 172 patients with VTE and 1 185 079 matched controls. This included 44 685 patients with a diagnosis of cancer at/or within 1 year before a VTE diagnosis. Female patients with VTE had a higher multivariable adjusted odds ratios of preceding cancer than male patients with VTE (5.5 [99% confidence interval 5.4-5.7] vs 3.9 [3.8-4.0]). The highest risk of cancer in patients with VTE were found for pancreatic cancer (women: 19.6 [15.8-24.4]; men: 17.2 [13.7-21.6]) and brain cancer (women: 17.4 [12.9-23.4]; men: 17.5 [13.8-22.2]). Weak associations were seen between VTE and bladder/urothelial cancer (women: 1.31 [1.12-1.53]; men: 1.34 [1.23-1.47]), prostate cancer (men: 2.17 [2.07-2.27]), malignant melanoma (women: 2.51 [2.07-3.05]; men: 2.67 [2.23-3.18]), and kidney cancer (women: 3.20 [2.49-4.11]; men: 3.33 [2.79-4.07]). In conclusion, associations with VTE were weak for bladder/urothelial cancer and kidney cancer, and strong for pancreatic, brain, and biliary cancers.

Thromboembolic complications in urogenital cancers: incidence, risk factors and prevention

“…Заболеваемость тромбоэмболиями при опухолях мочеполовой системы В ретроспективное общенациональное исследование «случай-контроль», проведенное в Швеции на основе ракового регистра, были включены 44 685 онкологических пациентов, у которых в течение года диагностирована ВТЭ [24]. Среди 813 пациентов с РП в 1,82 % случаев были выявлены ВТЭ, при этом женщин было 326 ( В ретроспективном исследовании среди 2762 пациентов с почечно-клеточным раком, перенесших радикальную или частичную нефрэктомию, совокупная частота ВТЭ за 1 и 5 лет составила 0,5 ± 0,1 и 1,5 ± 0,3 % соответственно [25].…”

The risk of recurrent venous thromboembolism after discontinuation of anticoagulant therapy in patients with cancer-associated thrombosis: a systematic review and meta-analysis

“… 2 This risk is especially high among patients with specific cancer types (including pancreatic, brain, lung, and ovarian cancer), immobile hospitalized patients with cancer, patients undergoing antineoplastic therapy and patients with metastatic disease. 2 , 3 , 4 , 5 , 6 The recommended therapy for cancer-associated thrombosis is anticoagulant therapy, as in patients without cancer. International guidelines suggest to use Factor Xa inhibitors (apixaban, edoxaban and rivaroxaban) or low-molecular-weight heparin (LMWH) for 3–6 months and to continue with anticoagulant therapy for as long as the cancer is active and the bleeding risk is acceptable.…”

A commentary on ‘Risk factors for incident venous thromboembolism in patients with renal tumor and inferior vena cava tumor thrombus: A retrospective case–control study’

“…Despite a recent trend toward earlier diagnosis of renal cell carcinoma (RCC), 4–10% of patients are still diagnosed with advanced disease and tumor invasion into the inferior vena cava 1 . Patients with kidney cancers, specifically RCCs, are at increased risk of venous thromboembolism (VTE), with rates varying between 1.2 and 3.5% 2 , 3 . To identify preoperative thrombotic risk factors in patients with renal tumor and inferior vena cava tumor thrombus, Wang et al .…”