Is there a benefit in computed tomography screening for cancer in patients with unprovoked proximal deep venous thrombosis? A cohort study in the Oxford University Hospitals <scp>NHS</scp> Trust

Hildyard, Catherine; Palmer, Jessica; Alhulail, Sarah; Zumbadze, G; Keeling, David

doi:10.1111/bjh.13547

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…21 Similarly, in a UK-based retrospective single-center study incorporating results from 62 CT scans carried out in the setting of unprovoked VTE, only 1 incidental cancer was detected (early urothelial carcinoma of the bladder), but 28 of these scans identified other incidental findings, which necessitated extensive follow-up investigations. 22,23 In another similar study consisting of results from 23 CT scans undertaken for the purposes of cancer screening, no cancers were detected but 5 individuals required further investigations based on the initial CT results. 23 Interestingly, a recent post hoc analysis of outcomes in specific subgroups of patients studied in the SOME trial suggests that age greater than 60 years, a previous diagnosis of provoked VTE, or a smoking history may be associated with an increased risk of occult malignancy in patients presenting with unprovoked VTE.…”

Section: Discussionmentioning

confidence: 99%

Screening for Malignancy in Patients With Unprovoked Venous Thromboembolism: A Single-Center Retrospective Case Series

Barrett

Kevane

Hall

et al. 2016

Clin Appl Thromb Hemost

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In this prospective review of cancer screening in unselected patients with unprovoked venous thromboembolism (VTE) presenting to a large teaching hospital in the Republic of Ireland, we aimed to determine the effects of the implementation of the National Institute for Health and Care Excellence screening policy in a "real-world" population. Within our institution, 64 individuals presented with unprovoked VTE during the study period, of whom 47 underwent a screening computed tomography (CT) scan. Two cases of previously undiagnosed cancer were identified. However, in both cases, the clinical history provided by the affected individuals would have prompted a CT scan regardless of the recommendations of the screening policy. The screening CT scans identified 18 incidental lesions within the cohort, which required further diagnostic studies. None of the additional investigations completed to date have detected any lesion of clinical significance. These findings support the view that cancer screening with CT imaging in unselected individuals with unprovoked VTE is not justified or cost-effective.

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Section: Discussionmentioning

confidence: 99%

Screening for Malignancy in Patients With Unprovoked Venous Thromboembolism: A Single-Center Retrospective Case Series

Barrett

Kevane

Hall

et al. 2016

Clin Appl Thromb Hemost

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“…A UK‐based retrospective single‐center evaluated 62 CT scans obtained in the setting of unprovoked VTE. With the imaging results, researchers were only able to identify one incidental cancer (early urothelial carcinoma of the bladder) 31 . However, 28 of these scans identified other incidental abnormalities, which necessitated extensive follow‐up investigations 31 .…”

Section: Benefit Of Enhanced Testing For Occult Malignancy In Unprovo...mentioning

confidence: 99%

“…With the imaging results, researchers were only able to identify one incidental cancer (early urothelial carcinoma of the bladder) 31 . However, 28 of these scans identified other incidental abnormalities, which necessitated extensive follow‐up investigations 31 . Another retrospective review of all ambulatory patients diagnosed with VTE in a London hospital, followed 239 patients after unprovoked VTE over a 24‐month period.…”

Section: Benefit Of Enhanced Testing For Occult Malignancy In Unprovo...mentioning

confidence: 99%

Screening for occult cancer after unprovoked venous thromboembolism: Assessing the current literature and future directions

Patel

Tao

McMurry

et al. 2022

European J of Haematology

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While significant evidence has established an increased rate of thrombosis in patients with cancer, the risk of occult malignancy in the setting of an unprovoked thrombosis is less clear. Despite continued interest in developing an effective screening system for occult malignancy following unprovoked venous thromboembolism (VTE), discrepancies in the literature and guideline recommendations leave providers uncertain whether to screen or perform further diagnostics for this patient population. Evidence suggests that screening for malignancy can detect cancer sooner in patients with unprovoked VTE, but there is a lack of high-quality evidence demonstrating improvements in survival who receive early detection. In the following manuscript, we summarize VTE in relation to cancer epidemiology and pathophysiology. Our literature review summarizes the spectrum of testing strategies for occult malignancy following unprovoked VTE, including biomarker detection methods and various imaging approaches. We evaluate the benefit of additional diagnostic strategies, review current guidelines on the issue, and provide guidance to the reader on the best practice for investigating undiagnosed malignancy in patients with unprovoked VTE.

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Screening for occult cancer in idiopathic venous thromboembolism — Systemic review and meta-analysis

Klein

Shepshelovich

Spectre

et al. 2017

European Journal of Internal Medicine

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Is there a benefit in computed tomography screening for cancer in patients with unprovoked proximal deep venous thrombosis? A cohort study in the Oxford University Hospitals NHS Trust

Cited by 3 publications

References 3 publications

Screening for Malignancy in Patients With Unprovoked Venous Thromboembolism: A Single-Center Retrospective Case Series

Screening for Malignancy in Patients With Unprovoked Venous Thromboembolism: A Single-Center Retrospective Case Series

Screening for occult cancer after unprovoked venous thromboembolism: Assessing the current literature and future directions

Screening for occult cancer in idiopathic venous thromboembolism — Systemic review and meta-analysis

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