What does this research mean for the field?

Clinically relevant bleeding is a common complication in cancer patients both preceding and following diagnosis, and its occurrence is independently associated with a significantly increased risk of mortality. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the prevalence and incidence of clinically relevant bleeding (CRB) in individuals with cancer and its association with mortality.

June 6, 2026American Journal of HematologyOpen Access

Clinically Relevant Bleeding in Individuals With Cancer: Insights From a Nationwide Cohort Study

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cancer (n=2455332). Intervention: Clinically relevant bleeding vs. No clinically relevant bleeding. Primary outcome: Mortality (HR 4.17, 95% CI 4.11-4.24).

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Key result

Clinically relevant bleeding linked to higher mortality in cancer patients, with intracranial hemorrhage raising risk ~317%.

HR 4.17
95% CI 4.11-4.24
n=2,455,332

Why the study?

While cancer-associated venous thromboembolism is widely studied, clinically relevant bleeding remains an underestimated threat with limited large-scale data.

What is the incidence of clinically relevant bleeding and its association with mortality in individuals with cancer?

Population

2 455 332 individuals with incident cancer encounters from 215 US health systems

Design

Nationwide retrospective cohort study

Follow-up

12-month window after cancer diagnosis

Authors

MLMing Y. Lim RGRadhika Gangaraju OJOmid Jafari

Discussion

Member takes

Overview

CRB warrants vigilance in cancer patients; leaves open whether prevention improves survival in prospective trials.

Key Points

To evaluate the prevalence and incidence of clinically relevant bleeding (CRB) in individuals with cancer and its association with mortality.
Analyzed data from 2,455,332 individuals with incident cancer encounters using the Epic Cosmos database.
Examined prevalence of CRB in the 12 months before and cumulative incidence in the 12 months after cancer diagnosis.
Performed multivariable analysis to assess factors associated with CRB and its impact on mortality.
CRB was prevalent in 5.3% of individuals before diagnosis and 6.3% after, reaching 7.0% in those receiving systemic therapy.
Factors linked to higher CRB incidence included certain cancer types, anticoagulant use, and previous VTE history.
Intracranial hemorrhage had the highest mortality risk (HR 4.17, 95% CI 4.11-4.24) associated with CRB.

Study Design

Type

Cohort (n=2,455,332)

Multicenter

Yes

Structured PICO

What is the incidence of clinically relevant bleeding and its association with mortality in individuals with cancer?

Population

2,455,332 individuals with incident cancer encounters from 215 US health systems between 2018 and 2024, evaluated for clinically relevant bleeding.

Outcome

Clinically relevant bleeding (CRB) and its association with mortalityhard clinical

Main Result

Hazard Ratio: 4.17 (95% CI 4.11–4.24)

Clinically relevant bleeding is a frequent complication in cancer patients, particularly those on anticoagulants, and is strongly associated with increased mortality.

Cite This Study

Lim et al. (2026) conducted a cohort in Cancer (n=2,455,332). Clinically relevant bleeding vs. No clinically relevant bleeding was evaluated on Mortality (HR 4.17, 95% CI 4.11-4.24). Clinically relevant bleeding was independently associated with mortality in cancer patients, including intracranial hemorrhage (HR 4.17; 95% CI 4.11-4.24) and gastrointestinal bleeding (HR 2.52).

synapsesocial.com/papers/6a23bb7971a5da9775e76f10 https://doi.org/10.1002/ajh.70394

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June 6, 2026American Journal of HematologyOpen Access

Clinically Relevant Bleeding in Individuals With Cancer: Insights From a Nationwide Cohort Study

View Full Paper

Ask AI

Bookmark

Key result

Clinically relevant bleeding linked to higher mortality in cancer patients, with intracranial hemorrhage raising risk ~317%.

HR 4.17
95% CI 4.11-4.24
n=2,455,332

Why the study?

While cancer-associated venous thromboembolism is widely studied, clinically relevant bleeding remains an underestimated threat with limited large-scale data.

What is the incidence of clinically relevant bleeding and its association with mortality in individuals with cancer?

Population

2 455 332 individuals with incident cancer encounters from 215 US health systems

Design

Nationwide retrospective cohort study

Follow-up

12-month window after cancer diagnosis

Authors

MLMing Y. Lim RGRadhika Gangaraju OJOmid Jafari

Discussion

Member takes

Overview

CRB warrants vigilance in cancer patients; leaves open whether prevention improves survival in prospective trials.

Key Points

To evaluate the prevalence and incidence of clinically relevant bleeding (CRB) in individuals with cancer and its association with mortality.
Analyzed data from 2,455,332 individuals with incident cancer encounters using the Epic Cosmos database.
Examined prevalence of CRB in the 12 months before and cumulative incidence in the 12 months after cancer diagnosis.
Performed multivariable analysis to assess factors associated with CRB and its impact on mortality.
CRB was prevalent in 5.3% of individuals before diagnosis and 6.3% after, reaching 7.0% in those receiving systemic therapy.
Factors linked to higher CRB incidence included certain cancer types, anticoagulant use, and previous VTE history.
Intracranial hemorrhage had the highest mortality risk (HR 4.17, 95% CI 4.11-4.24) associated with CRB.

Study Design

Type

Cohort (n=2,455,332)

Multicenter

Yes

Structured PICO

What is the incidence of clinically relevant bleeding and its association with mortality in individuals with cancer?

Population

2,455,332 individuals with incident cancer encounters from 215 US health systems between 2018 and 2024, evaluated for clinically relevant bleeding.

Outcome

Clinically relevant bleeding (CRB) and its association with mortalityhard clinical

Main Result

Hazard Ratio: 4.17 (95% CI 4.11–4.24)

Clinically relevant bleeding is a frequent complication in cancer patients, particularly those on anticoagulants, and is strongly associated with increased mortality.

Cite This Study

synapsesocial.com/papers/6a23bb7971a5da9775e76f10 https://doi.org/10.1002/ajh.70394

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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