Thromboembolism preceding cancer: A correlation study

Abstract

Thromboembolic (TE) events preceding cancer have been observed. Some studies failed to find this correlation. We retrospectively examined the cancer incidence following thromboembolic events in patients at our medical center. Medical records of 183 patients with established thromboembolic events documented in their records were selected and reviewed. Time interval between primary, secondary, and recurrent TE events preceding cancer diagnosis was analyzed. Two hundred age-and sex-matched controls seen during the same period and without any evidence of TE were randomly selected and charts reviewed for malignancy. Cancer occurred after TE in 48 of 183 patients (26.2%). In controls, cancer was diagnosed in 23 (11.5%). This was statistically significant with an odds ratio of 2.736 (1.586, 4.720). In the 64 primary TE patients, the cancer incidence was 37.5%. The 63 patients with recurrent TE had an incidence of 35.4%, and 56 secondary TE patients had an incidence of 27.1%. Time between initial TE and cancer diagnosis was <6 months in 27 (56.3%) patients, between 6 months and 1 year in 12 (25.0%), 1-5 years in 5 (10.4%), and >5 years in 4 (8.3%). Fourteen (31.1%) TE patients presented with metastatic cancer. This study indicates that thromboembolic events are important predictors of cancer. Cancer in this population occurs within a year in the majority of patients. Cancer screening in patients without identifiable risk factors for thrombosis could be helpful for early detection, diagnosis, and management of cancer. Am. J. Hematol. 72: 109-114, 2003.

Carbohydrate antigens as potential biomarkers for the malignancy in patients with idiopathic deep venous thrombosis: A retrospective cohort study

“…In line with previously reported incidence of 4%-26% of malignancies in DVT patients [16][17][18] , the incidence of tumors in patients with IDVT was 12.5% in our series. In view of this, we assumed that the incidence of tumors in DVT patients was 15% in the calculation of PPV and NPV.…”

Systematic screening for occult cancer in elderly patients with venous thromboembolism: a prospective study

“…Cancer is a well‐known risk factor for VTE, 6,7 which usually occurs in the advanced stages of the disease, but can also appear before the cancer has been diagnosed. Clinical studies show that the incidence of a new diagnosis of cancer increases significantly during the first 12 months after an initial episode of VTE, as compared with the general population; the incidence rises from 2% to 10% 8–13 . The most common cancers associated with VTE are adenocarcinomas that involve the gastrointestinal tract, ovary, lung, prostate and brain 14,15 .…”

Spontaneous free floating carotid artery thrombosis

“…A large retrospective study18 and an extensive systematic review19 showed thromboembolic events are important predictors of cancer. Cancer in these populations was diagnosed within a year in the majority of patients.…”

“…Either premalignant change promotes thrombosis, or cancer and thrombosis share common risk factors. Cancer screening in patients without identifiable risk factors for thrombosis could be helpful for early detection, diagnosis and management of cancer 18 19Learning points

Spontaneous carotid artery thrombosis is a rare condition.

Medical management with regular follow-up under the multidiscipilinary team is likely to be safe and effective.

Follow-up for carotid free floating thrombosis can be with either CT angiogram or ultrasound duplex.

Aetiology may not be immediately obvious and will require extensive investigation.

Cancer screening in patients without identifiable risk factors for thrombosis could be helpful for early detection, diagnosis and management of cancer.

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