Type of publication:
*Crawford E., *Moudgil H., *Naicker T., *Ahmad N., *Srinivasan K.
European Respiratory Journal, September 2014, vol./is. 44 Supp 58
UK guidance on the treatment of venous thromboembolism (VTE) recommends that patients with a first, unprovoked VTE should be screened for malignancy. This is based on two historical population-based studies which suggest that between 7.5 and 11% of patients diagnosed with an unprovoked VTE will develop cancer in the following two years. (Murchison, J. T. et al. Br J Cancer 2004;91(1):92-95. Baron, J.A. et al. Lancet 1998; 351(9109):1077-1080.) We wanted to compare local figures with this historical data in order to aid local guideline development. A retrospective case note review identified 417 patients within our institution diagnosed with VTE between January 2010 and January 2011. Ten of these patients (2%) developed cancer in the two years following diagnosis. Results In 2 out of 10 of these patients, tests performed as part of the routine work-up for VTE identified abnormalities that ultimately led to a diagnosis of cancer. None of the patients had extensive malignancy screening as advocated by current UK guidance. Within our local population, the risk of developing cancer in the two years following an unprovoked VTE appears to be significantly less than figures quoted in the literature. UK guidelines may not reflect current medical practice, which could be identifying cancer earlier, nor does it take into account the possibility of regional and national variations of disease. A cautious approach should be taken when counselling patients regarding future cancer risk and when considering further investigations for malignancy.
Link to more details or full-text: http://erj.ersjournals.com/content/44/Suppl_58/P4115