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Thromb Haemost 2022; 122(05): 662-665
DOI: 10.1055/a-1674-0259
Invited Mini Series: Novel Clinical Concepts in Thrombosis

Racial and Ethnic Disparities in Cancer-Associated Thrombosis

Courteney Wiredu
1   Department of Molecular Biology, Princeton University, Princeton, New Jersey, United States
,
Norrisa Haynes
2   Division of Cardiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
3   Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
,
Carmen Guerra
3   Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
4   Division of Internal Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
5   Abramson Cancer Center, Philadelphia, Pennsylvania, United States
6   Department of Epidemiology, Center for Clinical Epidemiology and Biostatistics, Philadelphia, Pennsylvania, United States
,
Bonnie Ky
2   Division of Cardiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
5   Abramson Cancer Center, Philadelphia, Pennsylvania, United States
6   Department of Epidemiology, Center for Clinical Epidemiology and Biostatistics, Philadelphia, Pennsylvania, United States
› Author Affiliations Funding C.W. was supported by a Penn Access Summer Scholars Program. B.K. is supported in part by an American Heart Association Award Strategically Focused Research Network Award in Cardio-Oncology Disparities.
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Abstract

Active malignancy increases the risk of developing venous thromboembolism (VTE) by four- to seven-fold. The risk of VTE, including deep vein thrombosis and pulmonary embolism, in patients with cancer varies based on several clinical factors, such as cancer stage and age. However, race and ethnicity are also associated with increased VTE risk. Black (African American) patients with cancer have a higher risk of developing VTE than White patients, while Asian/Pacific Islanders have a lower risk. Studies on cancer-associated thrombosis demonstrate a need to advance our understanding of both the biologic and sociologic underpinnings of the observed differences according to race. Addressing the causes of these disparities can better health outcomes for historically underserved patient populations.

Keywords

ethnic groups - neoplasms - race - risk factors - venous thromboembolism

Supplementary Material



Publication History

Received: 29 August 2021

Accepted: 18 October 2021

Accepted Manuscript online:
20 October 2021

Article published online:
20 January 2022

© 2021. Thieme. All rights reserved.

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  • References

  • 1 Jha AK, Larizgoitia I, Audera-Lopez C, Prasopa-Plaizier N, Waters H, Bates DW. The global burden of unsafe medical care: analytic modelling of observational studies. BMJ Qual Saf 2013; 22 (10) 809-815
    CrossrefPubMedGoogle Scholar
  • 2 Gervaso L, Dave H, Khorana AA. Venous and arterial thromboembolism in patients with cancer: JACC: CardioOncology state-of-the-art review. JACC CardioOncol 2021; 3 (02) 173-190
    CrossrefPubMedGoogle Scholar
  • 3 Addo-Tabiri NO, Chudasama R, Vasudeva R. et al. Black patients experience highest rates of cancer-associated venous thromboembolism. Am J Clin Oncol 2020; 43 (02) 94-100
    CrossrefPubMedGoogle Scholar
  • 4 Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH. Frequency, risk factors, and trends for venous thromboembolism among hospitalized cancer patients. Cancer 2007; 110 (10) 2339-2346
    CrossrefPubMedGoogle Scholar
  • 5 Heit JA, Beckman MG, Bockenstedt PL. et al; CDC Thrombosis and Hemostasis Centers Research and Prevention Network. Comparison of characteristics from White- and Black-Americans with venous thromboembolism: a cross-sectional study. Am J Hematol 2010; 85 (07) 467-471
    CrossrefPubMedGoogle Scholar
  • 6 Lutsey PL, Cushman M, Steffen LM. et al. Plasma hemostatic factors and endothelial markers in four racial/ethnic groups: the MESA study. J Thromb Haemost 2006; 4 (12) 2629-2635
    CrossrefPubMedGoogle Scholar
  • 7 Chekkal M, Rahal MCA, Moulasserdoun K, Seghier F. Increased level of factor VIII and physiological inhibitors of coagulation in patients with sickle cell disease. Indian J Hematol Blood Transfus 2017; 33 (02) 235-238
    CrossrefPubMedGoogle Scholar
  • 8 Tang L, Hu Y. Ethnic diversity in the genetics of venous thromboembolism. Thromb Haemost 2015; 114 (05) 901-909
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Goldhaber SZ. Race and venous thromboembolism: nature or nurture?. Circulation 2014; 129 (14) 1463-1465
    CrossrefPubMedGoogle Scholar
  • 10 Branchford BR, Carpenter SL. The role of inflammation in venous thromboembolism. Front Pediatr 2018; 6: 142
    CrossrefPubMedGoogle Scholar
  • 11 Paalani M, Lee JW, Haddad E, Tonstad S. Determinants of inflammatory markers in a bi-ethnic population. Ethn Dis 2011; 21 (02) 142-149
    PubMedGoogle Scholar
  • 12 Lee A, Cardel M, Donahoo WT. Social and environmental factors influencing obesity. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, Dungan K, Grossman A, Hershman JM, Hofland J, Kalra S, Kaltsas G, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, McGee EA, McLachlan R. et al., eds. Endotext. South Dartmouth, MA: MDText.com, Inc.; 2000
    Google Scholar
  • 13 C17001. Poverty Status in the Past 12 Months by Sex by Age [19] - American Community Survey Tables: 2009 — 2011 (3-Year Estimates) (ACS2011_3yr) - ACS 2011 (3-Year Estimates). Social Explorer.
    PubMed
  • 14 Slopen N, Lewis TT, Gruenewald TL. et al. Early life adversity and inflammation in African Americans and Whites in the midlife in the United States survey. Psychosom Med 2010; 72 (07) 694-701
    CrossrefPubMedGoogle Scholar
  • 15 Albert MA, Durazo EM, Slopen N. et al. Cumulative psychological stress and cardiovascular disease risk in middle aged and older women: rationale, design, and baseline characteristics. Am Heart J 2017; 192: 1-12
    CrossrefPubMedGoogle Scholar
  • 16 Bird CE, Seeman T, Escarce JJ. et al. Neighbourhood socioeconomic status and biological ‘wear and tear’ in a nationally representative sample of US adults. J Epidemiol Community Health 2010; 64 (10) 860-865
    CrossrefPubMedGoogle Scholar
  • 17 National Academies of Sciences, Engineering, and Medicine. The Root Causes of Health Inequity. Communities in Action: Pathways to Health Equity. 500 Fifth Street, NW Washington, DC 20001: The National Academies Press; 2017: 99-185
    PubMedGoogle Scholar
  • 18 Artiga S, Hill L, Orgera K, Damico A. Health Coverage by Race and Ethnicity, 2010–2019. KFF; 2021
    Google Scholar
  • 19 Effects of Health Insurance on Health. Care Without Coverage: Too Little, Too Late. National Academies Press (US); 2002
    Google Scholar
  • 20 Akinleye DD, McNutt L-A, Lazariu V, McLaughlin CC. Correlation between hospital finances and quality and safety of patient care. PLoS One 2019; 14 (08) e0219124
    CrossrefPubMedGoogle Scholar
  • 21 Nathan AS, Geng Z, Dayoub EJ. et al. Racial, ethnic, and socioeconomic inequities in the prescription of direct oral anticoagulants in patients with venous thromboembolism in the United States. Circ Cardiovasc Qual Outcomes 2019; 12 (04) e005600
    CrossrefPubMedGoogle Scholar
  • 22 McGarry LJ, Thompson D. Retrospective database analysis of the prevention of venous thromboembolism with low-molecular-weight heparin in acutely III medical inpatients in community practice. Clin Ther 2004; 26: 419-430
    CrossrefPubMedGoogle Scholar
  • 23 Fazal M, Malisa J, Rhee J-W, Witteles RM, Rodriguez F. Racial and ethnic disparities in cardio-oncology: a call to action. JACC CardioOncol 2021; 3 (02) 201-204
    CrossrefPubMedGoogle Scholar
  • 24 Thorlu -Bangura Z, Manisty C, Banerjee A. Understanding race and ethnicity in cancer and CV disease. JACC CardioOncology 2021; 3: 335-337
    CrossrefPubMedGoogle Scholar