Does cancer diagnosis in elderly patients with deep venous thrombosis modify the middle-term outcome?

Objectives: To assess whether cancer screening in elderly patients with deep venous thrombosis (DVT) could modify their outcome. Design: Prospective, case-control study. Setting: Department of internal medicine and gerontology at Angers University Hospital, from february 1999 to january 2000. The 5.8-year-follow-up was realized by means of postal questionnaires sent to patients’ family doctors. Participants: One hundred and eighteen DVT patients hospitalized for DVT were recruited and stratified into two groups (A and B) according to the age of 75 years and matched for 118 controls (groups C and D). Measurements: DVT was confirmed by a venous ultrasonography and cancer was screened by routine investigations. Outcome measures over 5.8 years: mortality rate and cancer diagnosis.Results: Cancer diagnosis during hospitalization was comparable between groups (A: 10.2% vs C: 5.1%, p = 0.488; B: 8% vs D: 0%, p = 0.06). After discharge, it was similar (A and C: 5.1%; B and D: 3.4%). Cancer related deaths were not “statistically” different (A: 6/21 vs C: 5/23, p = 0.85; B: 6/8 vs D: 1/5, p = 0.103). Mortality ratios were comparable (A: 35.6% vs C: 39%, p = 0.849; B: 13.5% vs D: 8.5%, p = 0.555), but a high mortality was noted in the group B as compared with group C (57% vs 8%; p = 0.0006) in the first year following DVT. Conclusion: Cancer diagnosis at the time of DVT does not modify outcomes of patients aged 75 years and older. Hence, a systematic screening for cancer among older patients could be unjustified. Other case-control studies are necessary to validate these results.