The Occurrence of Subsequent Malignancy in Patients Presenting with Deep Vein Thrombosis: Results from a Historical Cohort Study

Raghu Rajan; Mark Levine; Michael Gent; Jack Hirsh; William Geerts; Peter Skingley; Jim Julian

doi:10.1055/s-0037-1614211

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1998; 79(01): 19-22
DOI: 10.1055/s-0037-1614211

Review Article

Schattauer GmbH

The Occurrence of Subsequent Malignancy in Patients Presenting with Deep Vein Thrombosis: Results from a Historical Cohort Study

Raghu Rajan

¹From the Departments of Medicine and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton Civic Hospitals Research Centre, Hamilton, Ontario, and University of Toronto, Toronto, Ontario, Canada

,

Mark Levine

¹From the Departments of Medicine and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton Civic Hospitals Research Centre, Hamilton, Ontario, and University of Toronto, Toronto, Ontario, Canada

,

Michael Gent

¹From the Departments of Medicine and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton Civic Hospitals Research Centre, Hamilton, Ontario, and University of Toronto, Toronto, Ontario, Canada

,

Jack Hirsh

¹From the Departments of Medicine and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton Civic Hospitals Research Centre, Hamilton, Ontario, and University of Toronto, Toronto, Ontario, Canada

,

William Geerts

¹From the Departments of Medicine and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton Civic Hospitals Research Centre, Hamilton, Ontario, and University of Toronto, Toronto, Ontario, Canada

,

Peter Skingley

¹From the Departments of Medicine and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton Civic Hospitals Research Centre, Hamilton, Ontario, and University of Toronto, Toronto, Ontario, Canada

,

Jim Julian

¹From the Departments of Medicine and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton Civic Hospitals Research Centre, Hamilton, Ontario, and University of Toronto, Toronto, Ontario, Canada

› Author Affiliations

Abstract

Summary

Background: Several studies have reported that patients who present with idiopathic deep vein thrombosis (DVT) have an increased risk of subsequently developing cancer. A clinical trial had previously been conducted examining the optimal duration of oral anticoagulant therapy following initial heparin treatment in patients with proximal DVT.

Methods: A historical cohort study was performed on patients enrolled in the duration of anticoagulant trial. Patients known to have cancer at the time of entry into the trial were excluded. The qualifying DVTs were classified as idiopathic (no known associated risk factors) or secondary without knowledge of subsequent recurrent venous thrombosis or cancer. The patients were then followed for the development of cancer.

Results: Thirteen (8.6%) of the 152 patients in the idiopathic cohort subsequently developed cancer compared to eight (7.1%) of 112 patients in the secondary cohort, P = 0.86. Two (5.4%) of 37 patients with recurrent venous thromboembolism and 19 (8.4%) of 227 patients without recurrent thromboembolism developed cancer, P = 0.7.

Conclusion: Our study did not detect an increased risk of subsequent cancer in patients presenting with idiopathic DVT compared to secondary DVT; nor did we detect an increased incidence of cancer in patients with recurrent venous thromboembolism. Further studies are required prior to pursuing a policy of aggressive screening for cancer in patients with idiopathic venous thromboembolism.

Full Text

References

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