Underlying cancers in patients with unprovoked venous-thromboembolism

Underlying cancers are frequent in patients with unprovoked venous-thromboembolism (VTE). One in 10 patients will be diagnosed with a cancer within 12 months following the VTE. All patients with a newly diagnosed unprovoked VTE should have a complete medical history, physical examination, basic blood work (including complete blood count, liver function tests, renal function tests and calcium) and a chest X ray. Physicians should make sure that their patients are up to date regarding breast, cervical, colon and prostate cancer screening (according to National Guidelines). Any abnormalities on the above tests should be investigated as appropriate. It is still unclear if any other (or more extensive) tests should be performed on all patients with unprovoked VTE. Decision should be made on an individual basis after assessing the patient. If further test is warranted then computed tomography (CT) of the abdomen/pelvis provides the best yield of underlying malignancy detection. However, although CT abdomen/pelvis finds more cancers, it is unknown if this will translate into a better clinical outcomes (increased survival and quality of life) for patients

Bibliographic Reference

Carrier M et al.: "Systematic review: the Trousseau syndrome revisited: should we screen extensively for cancer in patients with venous thromboembolism?", Ann Intern Med. 2008 Sep 2;149(5):323-33

Marc Carrier, Marc Rodger

University of Ottawa and Ottawa Health Research Institute, Ottawa, Ontario, Canada