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DOES VENOUS THROMBOSIS MEAN OCCULT CANCER?

It is accepted that cancer can cause deep venous thrombosis, but the relation between the two is unclear. Investigators in Sweden retrospectively studied cancer rates among 3795 patients who had venography at one hospital between 1984 and 1988 and were not known to have cancer at the time.

Nearly 1400 patients had deep venous thrombosis; 11 percent of these were found to have cancer by 1991, versus 7.5 percent of the roughly 2400 patients without thrombosis. Malignancies developed within six months after venography in 66 patients with thrombosis and 37 without thrombosis (standardized morbidity ratio, 5.3 vs. 2.1).

Thirty-eight of the 66 patients with thrombosis and cancer had their cancer discovered via history, physical exam, or blood tests. The authors believe that 11 of the other 28 patients could have had their malignancy detected earlier through extensive screening, but they submit that only two of these would have benefited because of other clinical factors.

Comment: In this study, nearly 1400 people with deep venous thrombosis would have had to be subjected to extensive screening to make an earlier diagnosis of cancer in very few patients. Although this study confirms that thrombosis is associated with a higher risk for cancer (see also Journal Watch accession number 921016002), it does not support an extensive search for that cancer.

— KI Marton

Published in Journal Watch General Medicine May 13, 1994

Citation(s):

Nordstrom M et al. Deep venous thrombosis and occult malignancy: an epidemiological study. BMJ 1994 Apr 2 308 891-894.

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