Screening for occult malignancy can detect cancer sooner in patients with unprovoked VTE, but lacks high-quality evidence demonstrating improvements in survival.
Does screening for occult malignancy improve survival in patients with unprovoked venous thromboembolism?
Current evidence shows that while screening for occult cancer after unprovoked VTE detects malignancy earlier, it has not yet been shown to improve survival.
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.
Patel et al. (Tue,) conducted a review in Unprovoked venous thromboembolism (VTE). Screening for occult malignancy was evaluated. Screening for occult malignancy can detect cancer sooner in patients with unprovoked VTE, but lacks high-quality evidence demonstrating improvements in survival.