Cancer and venous thromboembolism

Previous case reports, autopsy series, and another cohort study1have demonstrated a clinically important and statistically significant association between occult cancer and pulmonary embolism. The study by Goldberg et al2extends this finding to a far more common clinical condition than pulmonary embolism, namely, deep venous thrombosis (DVT). In this study, 370 patients with DVT (diagnosed by impedance plethysmography IPG) who did not have overt cancer were compared with 1073 patients suspected of DVT but who had normal IPGs (and no overt cancer). During five years of follow-up, of those with DVT, 6.3% developed cancer, compared with 2.4% of those who had negative IPGs. Thus, in the population that was investigated, the relative risk for developing cancer in the presence of DVT was 2.7, with 95% confidence limits from 1.5 to 4.7. The most frequent sites of cancer were lung and colon, and the majority developed within two