Epidemiology of cancer-associated venous thrombosis

Abstract

Cancer-associated venous thrombosis is a common condition, although the reported incidence varies widely between studies depending on patient population, start and duration of follow-up, and the method of detecting and reporting thrombotic events. Furthermore, as cancer is a heterogeneous disease, the risk of venous thrombosis depends on cancer types and stages, treatment measures, and patient-related factors. In general, cancer patients with venous thrombosis do not fare well and have an increased mortality compared with cancer patients without. This may be explained by the more aggressive type of malignancies associated with this condition. It is hypothesized that thromboprophylaxis in cancer patients might improve prognosis and quality of life by preventing thrombotic events. However, anticoagulant treatment leads to increased bleeding, particularly in this patient group, so in case of proven benefit of thromboprophylaxis, only patients with a high risk of venous thrombosis should be considered. This review describes the literature on incidence of and risk factors for cancer-associated venous thrombosis, with the aim to provide a basis for identification of high-risk patients and for further development and refinement of prediction models. Furthermore, knowledge on risk factors for cancer-related venous thrombosis may enhance the understanding of the pathophysiology of thrombosis in these patients.

Efficacy and Safety of Edoxaban in Patients With Active Malignancy and Atrial Fibrillation: Analysis of the ENGAGE AF‐TIMI 48 Trial

“…Although 20‐year incident malignancy in patients with new‐onset AF has been reportedly low at 10%,4 incident AF may occur in up to 30% of patients with certain types of malignancy (eg, thoracic) 6. Cancer‐associated thrombosis has been well described,7, 8 and AF in patients with malignancy may independently double the risk of venous or arterial thromboembolism compared with either condition alone 9. Some malignancies may also inherently increase the risk for major bleeding in patients with AF (eg, hematologic cancer),6 which is potentiated further with anticoagulant therapy 10, 11…”

Superior Sagittal Sinus Thrombosis as the Initial Presentation of Renal Cell Carcinoma

“…Venous thromboembolism is nearly seven times more likely to occur in certain cohorts of cancer patients and acts as a potential cause of mortality (1,2). Th e pathogenesis of the hypercoagulable state of malignancy involves multiple factors (3).…”

Cancer‐associated thrombosis: The search for the holy grail continues

“…Among all patients with VTE, approximately one in five is diagnosed with cancer, whereas cancer patients have a four‐ to seven‐fold increased risk for a VTE event 1, 2, 3. Furthermore, cancer‐associated thrombosis (CAT) contributes to high morbidity and mortality, with VTE being the second cause of death—after cancer, itself 4, 5. Besides the “classical” patient‐related factors like age, ethnicity and prior history of VTE, several other risk factors intrinsic to cancer that may contribute to CAT have been addressed, such as higher tumor grade, metastatic disease, and cancer type.…”