The Risk of a Diagnosis of Cancer after Primary Deep Venous Thrombosis or Pulmonary Embolism

Abstract

An aggressive search for a hidden cancer in a patient with a primary deep venous thrombosis or pulmonary embolism is not warranted.

The risk of a second cancer after hospitalisation for venous thromboembolism

“…The associations we observed with second cancers parallels that for a first malignancy, in which risk is also increased soon after a thrombotic episode (Baron et al, 1998;Sørensen et al, 1998;Prandoni, 2002). The spectrum of thrombosis-associated second cancers is very similar to that for first cancers (Baron et al, 1998;Sørensen et al, 1998), and thus similar aetiologic factors may be at play.…”

“…The spectrum of thrombosis-associated second cancers is very similar to that for first cancers (Baron et al, 1998;Sørensen et al, 1998), and thus similar aetiologic factors may be at play.…”

“…Patients with clinically overt cancer may develop venous thromboembolism (VTE) at any stage of the disease (Agnelli, 1997;Rickles and Levine, 2001), aggravated by surgery, chemotherapy and intravenous catheters (Rickles and Levine, 2001). Occasionally, the thromboembolic event may occur before the clinical presentation of the cancer, and it is well known that the risk of a first cancer diagnosis is greatly increased in the year immediately after VTE (Prandoni et al, 1992;Baron et al, 1998;Sørensen et al, 1998Sørensen et al, , 2000Murchison et al, 2004).…”

Increased risk of venous thromboembolism in patients with acute leukaemia

“…Since the first report back in 1868 (Trousseau, 1868), many publications have dealt with the association of thromboembolic and malignant diseases (Prandoni et al, 1992;Baron et al, 1998;Sorensen et al, 1998;Sutherland et al, 2002;Deitcher, 2003;Lee et al, 2003;Murchison et al, 2004;Otten et al, 2004). A recently published study reported VTE in 7.6% of 1041 patients with solid tumours (Sallah et al, 2002), whereas we found VTE in 7.7% of 1038 patients with malignant lymphoma with a higher incidence in high-grade than in low-grade lymphoma (Mohren et al, 2005).…”

Venous thromboembolism and subsequent short-term risk of an occult cancer

“…The study by Trujillo-Santos et al has three important clinical messages: (i) the rate of occult cancer detected after venous thromboembolism is low, even lower than previously reported in large population-based studies [8,9]; (ii) some simple clinical predictors are associated with the detection of an occult cancer, but the absolute risk is low both in patients with positive and negative predictors; and (iii) occult cancer has a poor prognosis and the likelihood of a better outcome by early detection is questionable. These findings provide room for some optimism, particularly in light of increasing evidence that low-molecular-weight heparin may improve survival in patients with venous thromboembolism and cancer, and may reduce the risk of complications [11].…”