Hospitalisation for venous thromboembolism in cancer patients and the general population: a population-based cohort study in Denmark, 1997–2006

• Published in: British journal of cancer Vol. 103; no. 7; pp. 947 - 953
• Main Authors: Cronin-Fenton, D P, Søndergaard, F, Pedersen, L A, Fryzek, J P, Cetin, K, Acquavella, J, Baron, J A, Sørensen, H T
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 28.09.2010; Nature Publishing Group
• Subjects: 692/699/67; 692/699/75/593/1839; 692/700/478/174; Aged; Aged, 80 and over; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Blood and lymphatic vessels; Brain cancer; Brain research; Cancer Research; Cancer therapies; Cardiology. Vascular system; Chemotherapy; Clinical Study; Cohort analysis; Cohort Studies; Comorbidity; Denmark; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Drug Resistance; Epidemiology; Female; Hospitalization; Hospitals; Humans; Male; Medical diagnosis; Medical research; Medical sciences; Middle Aged; Molecular Medicine; Multiple myeloma; Neoplasms - complications; Oncology; Population Surveillance; Registration; Risk Assessment; Skin cancer; Thromboembolism; Thrombosis; Tumors; Venous Thromboembolism - epidemiology; Denmark; Europe; United States > US; Aarhus Denmark; epidemiology; treatment; incidence rate; venous thromboembolism; Human; Deep vein thrombosis; Cardiovascular disease; Malignant tumor; Epidemiology; Venous disease; Incidence; Vascular disease; Cancerology; Treatment; Cohort study; Venous thrombosis; Thromboembolism; Cancer
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/sj.bjc.6605883

Background: Venous thromboembolism (VTE) frequently complicates cancer. Data on tumour-specific VTE predictors are limited, but may inform strategies to prevent thrombosis. Methods: We computed incidence rates (IRs) with 95% confidence intervals (CIs) for VTE hospitalisation in a cohort of cancer patients ( n =57 591) and in a comparison general-population cohort ( n =287 476) in Denmark. The subjects entered the study in 1997–2005, and the follow-up continued through 2006. Using Cox proportional-hazards regression, we estimated relative risks (RRs) for VTE predictors, while adjusting for comorbidity. Results: Throughout the follow-up, VTE IR was higher among the cancer patients (IR=8.0, 95% CI=7.6–8.5) than the general population (IR=4.7, 95% CI=4.3–5.1), particularly in the first year after cancer diagnosis (IR=15.0, 95% CI=13.8–16.2, vs IR=8.6, 95% CI=7.6–9.9). Incidence rates of VTE were highest in patients with pancreas (IR=40.9, 95% CI=29.5–56.7), brain (IR=17.7, 95% CI=11.3–27.8) or liver (IR=20.4, 95% CI=9.2–45.3) tumours, multiple myeloma (IR=22.6, 95% CI=15.4–33.2) and among patients with advanced-stage cancers (IR=27.7, 95% CI=24.0–32.0) or those who received chemotherapy or no/symptomatic treatment. The adjusted RR (aRR) for VTE was highest among patients with pancreas (aRR=16.3, 95% CI=8.1–32.6) or brain cancer (aRR=19.8 95% CI=7.1–55.2), multiple myeloma (aRR=46.1, 95% CI=13.1–162.0) and among patients receiving chemotherapy, either alone (aRR=18.5, 95% CI=11.9–28.7) or in combination treatments (aRR=16.2, 95% CI=12.0–21.7). Conclusions: Risk of VTE is higher among cancer patients than in the general population. Predictors of VTE include recency of cancer diagnosis, cancer site, stage and the type of cancer-directed treatment.