The risk of a second cancer after hospitalisation for venous thromboembolism

Abstract

Although venous thromboembolism (VTE) is common in patients with cancer, it is not known if it is associated with risk of a second malignancy. Using the Danish Cancer Registry and National Registry of Patients, we studied a population-based cohort of 6285 patients with cancer who had an episode of VTE. The risk of a second cancer was compared with that among 30 713 cancer patients without VTE, matched for age, sex, cancer site and year of diagnosis. Overall, the relative risk for a second cancer diagnosis was 1.3 (95% confidence interval (CI) 1.1 -1.4). However, the excess risk varied with the time from the initial cancer diagnosis to the thrombotic event. If the thrombotic episode occurred within the first year, the relative risk for a second cancer was 1.0 (95% CI 0.9 -1.3), but if the VTE occurred more than 1 year after the initial cancer, the overall relative risk for a second cancer was 1.4 (95% CI 1.2 -1.7), with strong associations for cancers of the digestive organs, ovary and prostate. The association between VTE and subsequent incident cancer extends to patients who already have had a cancer diagnosis.

Cancer and Venous Thromboembolism. Clinical Implications of Strong Association

“…The risk of cancer is higher in patients with recurrent thromboembolism [33], in those with bilateral VTE [34], and in those with a high D-dimer value at the time of patient referral with VTE [35]. These findings have been confirmed by those of four large, population-based studies conducted in Denmark, Sweden, Scotland,and U.S.A., respectively [36][37][38][39][40]. Of interest, the association between VTE and subsequent incident cancer may extend to patients who already have had a cancer diagnosis [41].…”

Venous thromboembolism and cancer: a systematic review

“…The prevalence of asymptomatic VTE also increases with cancer progression, being present in half of hospitalized patients [19] and PE is noted in 30-50% of patients with cancer at autopsy [20,21]. In addition, patients withcancer and associated VTE had a higher risk of development of a second malignancy when compared to cancer patients without associated VTE [22].…”

ICD-10 hospital discharge diagnosis codes were sensitive for identifying pulmonary embolism but not deep vein thrombosis

“…These codes had been determined by searching the ICD-10 and reviewing published literature [6,15,24]. In accordance with previous studies [25], we allowed the VTE codes to be in any position (i.e., primary or secondary discharge diagnosis codes).…”