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The long-term risk of cancer in patients with a first episode of venous thromboembolism.
J Thromb Haemost 2009; 7(4):546-51JT

Abstract

BACKGROUND

In patients with venous thromboembolism (VTE), 15-20% will have prevalent cancer when VTE is diagnosed but little is known about such patients' long-term risk, time course and predictors of new cancer.

PATIENTS AND METHODS

We studied an inception cohort of patients with a first VTE who were not diagnosed with cancer within 3 months after VTE and who had follow-up for up to 120 months. We determined the annual risk for a new cancer [number of events and 95% confidence interval (CI)] per 100 person-years in all patients and in those with unprovoked VTE and identified predictors for new cancer.

RESULTS

We studied 1852 patients with VTE who received anticoagulant therapy for 12 months (mean) and were followed for 4.2 years (mean). During follow-up, there were 105 (5.7%) patients diagnosed with new cancer during the period after the initial 3 months from diagnosis, for an annual risk of 1.32 (CI, 1.09-1.60) per 100 person-years. The risk for new cancer appeared uniform over time. The annual risk for new cancer was more than 2-fold higher in patients presenting with unprovoked compared with those with provoked VTE [1.76 (CI, 1.39-2.20) vs. 0.83 (CI, 0.58-1.16) per 100 person-years; P<0.001]. Clinical predictors for new cancer were increasing age [hazard ratio (HR), 1.23; CI, 1.05-1.44] and unprovoked VTE (HR, 1.86; CI, 1.21-2.87).

CONCLUSION

In patients with a first VTE and without prevalent cancer, the risk for new cancer is about 1-2% per year, appears to be uniform over time, and is higher in patients with unprovoked VTE and those with advanced age.

Authors+Show Affiliations

Department of Medicine, McMaster University, Hamilton, ON, Canada. jdouket@mcmaster.ca

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19143921

Citation

Douketis, J D., et al. "The Long-term Risk of Cancer in Patients With a First Episode of Venous Thromboembolism." Journal of Thrombosis and Haemostasis : JTH, vol. 7, no. 4, 2009, pp. 546-51.
Douketis JD, Gu C, Piccioli A, et al. The long-term risk of cancer in patients with a first episode of venous thromboembolism. J Thromb Haemost. 2009;7(4):546-51.
Douketis, J. D., Gu, C., Piccioli, A., Ghirarduzzi, A., Pengo, V., & Prandoni, P. (2009). The long-term risk of cancer in patients with a first episode of venous thromboembolism. Journal of Thrombosis and Haemostasis : JTH, 7(4), pp. 546-51. doi:10.1111/j.1538-7836.2008.03268.x.
Douketis JD, et al. The Long-term Risk of Cancer in Patients With a First Episode of Venous Thromboembolism. J Thromb Haemost. 2009;7(4):546-51. PubMed PMID: 19143921.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The long-term risk of cancer in patients with a first episode of venous thromboembolism. AU - Douketis,J D, AU - Gu,C, AU - Piccioli,A, AU - Ghirarduzzi,A, AU - Pengo,V, AU - Prandoni,P, Y1 - 2008/12/22/ PY - 2009/1/16/entrez PY - 2009/1/16/pubmed PY - 2009/8/18/medline SP - 546 EP - 51 JF - Journal of thrombosis and haemostasis : JTH JO - J. Thromb. Haemost. VL - 7 IS - 4 N2 - BACKGROUND: In patients with venous thromboembolism (VTE), 15-20% will have prevalent cancer when VTE is diagnosed but little is known about such patients' long-term risk, time course and predictors of new cancer. PATIENTS AND METHODS: We studied an inception cohort of patients with a first VTE who were not diagnosed with cancer within 3 months after VTE and who had follow-up for up to 120 months. We determined the annual risk for a new cancer [number of events and 95% confidence interval (CI)] per 100 person-years in all patients and in those with unprovoked VTE and identified predictors for new cancer. RESULTS: We studied 1852 patients with VTE who received anticoagulant therapy for 12 months (mean) and were followed for 4.2 years (mean). During follow-up, there were 105 (5.7%) patients diagnosed with new cancer during the period after the initial 3 months from diagnosis, for an annual risk of 1.32 (CI, 1.09-1.60) per 100 person-years. The risk for new cancer appeared uniform over time. The annual risk for new cancer was more than 2-fold higher in patients presenting with unprovoked compared with those with provoked VTE [1.76 (CI, 1.39-2.20) vs. 0.83 (CI, 0.58-1.16) per 100 person-years; P<0.001]. Clinical predictors for new cancer were increasing age [hazard ratio (HR), 1.23; CI, 1.05-1.44] and unprovoked VTE (HR, 1.86; CI, 1.21-2.87). CONCLUSION: In patients with a first VTE and without prevalent cancer, the risk for new cancer is about 1-2% per year, appears to be uniform over time, and is higher in patients with unprovoked VTE and those with advanced age. SN - 1538-7836 UR - https://www.unboundmedicine.com/medline/citation/19143921/The_long_term_risk_of_cancer_in_patients_with_a_first_episode_of_venous_thromboembolism_ L2 - https://doi.org/10.1111/j.1538-7836.2008.03268.x DB - PRIME DP - Unbound Medicine ER -