More advanced cancer at diagnosis was associated with a higher VTE risk compared to localized disease, with the incidence rate difference reaching 187.0 × 10−3 person-years for pancreatic cancer.
Cohort (n=144,952)
Does advanced cancer stage increase the incidence of venous thromboembolism compared to localized disease in patients with solid cancers?
More advanced cancer at diagnosis is associated with a higher risk of VTE, but the magnitude of this risk varies substantially depending on the specific cancer type.
Effect estimate: IRD 187.0 × 10−3 p-y (pancreatic cancer) (95% CI -6.7 to 380.8)
Essentials•Impact of cancer stage on venous thromboembolism (VTE) risk is not well‐known in all cancers.•The Scandinavian Thrombosis and Cancer Cohort provides person‐time data and validated VTEs.•Impact of cancer stage on VTE incidence tended to vary with cancer type.•Cancer stage may not per se be a risk factor for VTE in all cancer types.Summary. BackgroundAbsolute measures of the impact of cancer stage on the incidence of venous thromboembolism (VTE) in patients with distinct cancer types have not been investigated in a large population‐based cohort study.ObjectivesTo investigate differences in the incidence rates of objectively confirmed VTE according to the development of cancer in a large population‐based cohort study. Cancer type and stage at the time of diagnosis were taken into account.Patients and MethodsThe Scandinavian Thrombosis and Cancer Cohort includes data regarding cancer types, stages and objectively confirmed VTE diagnoses among 144 952 participants followed from 1993 to 2012. We studied stage‐specific incidence rates of VTE, and calculated incidence rate differences (IRDs) for VTE according to stages in patients with 10 types of solid cancer.ResultsDuring the entire follow‐up, 335 VTEs occurred, of which 293 occurred within 5 years. The IRD of VTE in patients with distant metastasis as compared with those with localized disease indicated large variation depending on cancer type. The highest IRD was observed for pancreatic cancer (IRD of 187.0 × 10−3 person‐years p‐y; 95% confidence interval CI − 6.7 to 380.8), and the lowest IRD was observed for prostate cancer (IRD of 3.7 × 10−3 p‐y; 95% CI − 7 to 15.2). Regional spread as compared with localized disease also indicated large variation depending on cancer type; the highest IRD was observed for uterine cancer (IRD of 37.6 × 10−3 p‐y; 95% CI − 23.7 to 99), and the IRDs for breast and prostate cancer were close to zero.ConclusionMore advanced cancer at the time of diagnosis was associated with a higher risk of VTE, but the strength of the associations differed substantially between cancer types. Essentials•Impact of cancer stage on venous thromboembolism (VTE) risk is not well‐known in all cancers.•The Scandinavian Thrombosis and Cancer Cohort provides person‐time data and validated VTEs.•Impact of cancer stage on VTE incidence tended to vary with cancer type.•Cancer stage may not per se be a risk factor for VTE in all cancer types. •Impact of cancer stage on venous thromboembolism (VTE) risk is not well‐known in all cancers.•The Scandinavian Thrombosis and Cancer Cohort provides person‐time data and validated VTEs.•Impact of cancer stage on VTE incidence tended to vary with cancer type.•Cancer stage may not per se be a risk factor for VTE in all cancer types. Absolute measures of the impact of cancer stage on the incidence of venous thromboembolism (VTE) in patients with distinct cancer types have not been investigated in a large population‐based cohort study. To investigate differences in the incidence rates of objectively confirmed VTE according to the development of cancer in a large population‐based cohort study. Cancer type and stage at the time of diagnosis were taken into account. The Scandinavian Thrombosis and Cancer Cohort includes data regarding cancer types, stages and objectively confirmed VTE diagnoses among 144 952 participants followed from 1993 to 2012. We studied stage‐specific incidence rates of VTE, and calculated incidence rate differences (IRDs) for VTE according to stages in patients with 10 types of solid cancer. During the entire follow‐up, 335 VTEs occurred, of which 293 occurred within 5 years. The IRD of VTE in patients with distant metastasis as compared with those with localized disease indicated large variation depending on cancer type. The highest IRD was observed for pancreatic cancer (IRD of 187.0 × 10−3 person‐years p‐y; 95% confidence interval CI − 6.7 to 380.8), and the lowest IRD was observed for prostate cancer (IRD of 3.7 × 10−3 p‐y; 95% CI − 7 to 15.2). Regional spread as compared with localized disease also indicated large variation depending on cancer type; the highest IRD was observed for uterine cancer (IRD of 37.6 × 10−3 p‐y; 95% CI − 23.7 to 99), and the IRDs for breast and prostate cancer were close to zero. More advanced cancer at the time of diagnosis was associated with a higher risk of VTE, but the strength of the associations differed substantially between cancer types.
Gade et al. (Tue,) conducted a cohort in Solid cancer (n=144,952). Advanced cancer stage (distant metastasis or regional spread) vs. Localized disease was evaluated on Objectively confirmed venous thromboembolism (VTE) (IRD 187.0 × 10−3 p-y (pancreatic cancer), 95% CI -6.7 to 380.8). More advanced cancer at diagnosis was associated with a higher VTE risk compared to localized disease, with the incidence rate difference reaching 187.0 × 10−3 person-years for pancreatic cancer.