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CANCER AND DEEP VENOUS THROMBOSIS.

Because of an association between cancer and deep venous thrombosis (DVT), some authorities have recommended that persons with idiopathic DVT be evaluated for occult malignancy. This study suggests that extensive evaluations in such persons are not necessary.

Participants were 986 consecutive patients with no known risk factors for DVT who were referred for venous ultrasonography because idiopathic DVT was suspected. DVT was diagnosed in 142 patients. During hospitalization, cancer was detected in 16 of these patients (12 percent). All sixteen had at least one abnormal finding on history (e.g., weight loss), physical exam (e.g., abdominal mass), lab tests (e.g., anemia), or chest x-rays. Cancer was diagnosed in none of the 56 patients with DVT who did not have abnormal findings. During a median follow-up of 34 months, cancer was diagnosed in an additional 2.5 percent of patients with DVT and in 2.7 percent of those without DVT.

Comment: These findings support many current pragmatic recommendations that work-ups for malignancy in patients with DVT should be limited to those with symptoms and signs suggestive of cancer.

— CD Mulrow

Published in Journal Watch General Medicine November 29, 1996

Citation(s):

Cornuz J et al. Importance of findings on the initial evaluation for cancer in patients with symptomatic idiopathic deep venous thrombosis. Ann Intern Med 1996 Nov 15 125 785-793.

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