The incidence of cancer-associated thrombosis is increasing over time

Abstract

Cancer associated thrombosis (CAT) is an important cause of morbidity and mortality for patients with malignancy and varies by primary cancer type, stage and therapy. We aimed to characterize the incidence, risk factors, temporal trends and the effect on mortality of CAT. The California Cancer Registry was linked to the statewide hospitalization database to identify individuals with the 13 most common malignancies diagnosed 2005 -2017 and determine the 6 and 12-month cumulative incidence of CAT by venous thromboembolism (VTE) location, tumor type and stage after adjusting for competing risk of death. Cox proportional hazard regression models were used to determine risk factors associated with CAT and the effect of CAT on all-cause mortality. 942,019 patients with cancer were identified; 62,003 (6.6%) had an incident diagnosis of CAT. Patients with pancreatic, brain, ovarian, and lung cancer had the highest and patients with breast and prostate cancer had the lowest 12-month cumulative incidence of CAT. For most malignancies, men, those with metastatic disease and more co-morbidities, and African-Americans (vs. non-Hispanic Whites) were at highest risk for CAT. Patients diagnosed with cancer 2014-2017 had higher risk of CAT compared to those diagnosed 2005-2007. CAT was associated with increased overall mortality for all malignancies (HR ranges 1.89 - 4.79). The incidence of CAT increased over time and was driven by an increase in PE±DVT. CAT incidence varies based on tumor type and stage, and on individual risk factors including gender, race/ethnicity, and co-morbidities. For all tumor types CAT is associated with an increased mortality.

Thromboembolic Disease in Patients With Cancer and COVID-19: Risk Factors, Prevention and Practical Thromboprophylaxis Recommendations–State-of-the-Art

“…Each cancer type carries a differential intrinsic risk for thrombosis. Pancreatic and gastric cancers are associated with the highest thrombotic risk, followed by lung, testicular, gynecologic, bladder and central nervous system cancers, which are also frequently complicated with VTE (73). However, prostate cancer, breast cancer, and melanoma are less commonly associated with VTE (58).…”

Venous Thromboembolism in Women with Cancer with an Additional Focus on Breast and Gynecological Cancers

“…1 In parallel to this, the number of cancer-associated venous thromboembolisms (VTEs) also rises. [2][3][4] One in 12 cancer patients will develop VTE. VTE often heralds cancer progression and indicates a poorer prognosis ("signum malum").…”

Management of Cancer-Associated Thrombosis in France: A National Survey among Vascular Disease and Supportive Care Specialists

“…According to various studies, VTE represents one of the most important causes of morbidity in cancer patients, affecting up to 20% of patients with cancer, and the occurrence of VTE is associated with increased mortality [ 1 ]. Of note, the incidence of cancer-associated thrombosis (CAT) has increased over time [ 1 , 2 ].…”