The impact of initial cancer stage on the incidence of venous thromboembolism: the Scandinavian Thrombosis and Cancer (STAC) Cohort

Publikation: Forskning - peer reviewTidsskriftartikel

DOI

  • I L Gade
    I L GadeDepartment of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Haematology, Aalborg University Hospital, Aalborg, Denmark.
  • Sigrid K Braekkan
    Sigrid K BraekkanHematological Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.Norge
  • Inger Anne Næss
    Inger Anne NæssDepartment of Hematology, Trondheim University Hospital, Trondheim, Norway.Norge
  • J.B. Hansen
    J.B. HansenDepartment of Clinical Medicine, K. G. Jebsen Thrombosis Research and Expertise Center (TREC), UiT The Arctic University of Norway, Tromsø, Norway.Hematological Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.Norge
  • Suzanne C Cannegieter
    Suzanne C CannegieterDepartment of Clinical Epidemiology, Leiden University Medical Center, University of Leiden, Leiden, the Netherlands.Holland
  • Kim Overvad
  • Hilde Jensvoll
    Hilde JensvollHematological Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.Norge
  • Jens Hammerstrøm
    Jens HammerstrømDepartment of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.Norge
  • Kristine Blix
    Kristine BlixHematological Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.Norge
  • A. Tjønneland
    A. TjønnelandDepartment of Diet, Genes and Environment, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark.Danmark
  • S R Kristensen
  • M T Severinsen

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: Background 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. Objectives 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. Patients and Methods 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. Results 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. Conclusion 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.

OriginalsprogEngelsk
TidsskriftJournal of Thrombosis and Haemostasis
Vol/bind15
Tidsskriftsnummer8
Sider (fra-til)1567-1575
Antal sider9
ISSN1538-7933
DOI
StatusUdgivet - aug. 2017

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