Incidences and risk factors for venous thrombosis as discussed in the review
| Topic . | Study population . | Study design . | Number of patients . | Effect estimate . | Reference . |
|---|---|---|---|---|---|
| Proportion of cancer-associated VT cases | Olmsted county population | Nested case-control | 625/625 | 18% (PAR) | 5 |
| California Discharge DataSet | Cohort | 21 002 | 21% | 9 | |
| Worcester metropolitan area, outpatient setting | Cohort | 1399 | 29% | 8 | |
| RIETE Registry | Cohort | 35 539 | 17% | 4 | |
| Tromsø Study | Cohort | 462 | 23% | 3 | |
| RR of VT for cancer vs no cancer | MEGA study | Case-control | 2131/3220 | OR 6.7 (95% CI; 5.2-8.6) | 10 |
| Olmsted county population | Nested case-control | 625/625 | OR 4.1 (95% CI; 1.9-8.5) | 12 | |
| Linked United Kingdom databases | Cohort | 82 203/577 207 | HR 4.7 (95% CI; 4.5-4.9) | 13 | |
| Danish population-based registries | Cohort | 57 591/287 476 | HR 4.7 (95% CI; 4.3-5.1) | 11 | |
| Absolute risk of VT in cancer patients | Linkage of California Cancer Registry and California Discharge Dataset | Cohort | 235 149 | 1.6% within 2 y | 14 |
| Referred patients with solid tumors | Cohort | 1041 | 7.8% (median follow-up 26 mo) | 15 | |
| CATS study | Cohort | 840 | 8% within 1 y | 16 | |
| 38 papers on cohorts with cancer patients | Meta-analysis | NA | 13/1000 PY (95% CI; 7-23) for average-risk patients | 17 | |
| 68/1000 PY (95% CI; 48-96) for high-risk patients | 17 | ||||
| Linked United Kingdom databases | Cohort | 82 203 | 14/1000 PY (95% CI; 13-14) | 13 | |
| Incidence of VT in cancer patients over time | US National Hospital Discharge Survey | Cohort | 40 787 000 | 1.5% in 1989; 3.5% in 1999 | 19 |
| Discharge Database from University HealthSystem Consortium | Cohort | 1 015 598 | ∼3.5% in 1995; ∼4.5% in 2002 | 18 | |
| Linked United Kingdom databases | Cohort | 82 203 | 10.3/1000 PY in 1997; 19/1000 PY in 2006 | 13 | |
| Risk factors for VT in cancer patients | |||||
| Type of cancer | 38 papers on cohorts with cancer patients | Meta-analysis | NA | Pancreatic cancer: ∼110/1000 PY | 17 |
| Brain cancer: ∼80/1000 PY | |||||
| Lung cancer: ∼45/1000 PY | |||||
| Haematologic cancer: ∼40/1000 PY | |||||
| Colorectal cancer: ∼30/1000 PY | |||||
| Bone cancer: ∼30/1000 PY | |||||
| Prostate cancer: ∼10/1000 PY | |||||
| Breast cancer: ∼10/1000 PY | |||||
| Stage of cancer | Danish population-based registries | Cohort | 40 994/204 970 | HRs 2.9, 2.9, 7.5, and 17.1 for stage I, II, III, and IV cancer patients, respectively, vs general population | 11 |
| Linkage of California Cancer Registry and California Discharge Dataset | Cohort | 235 149 | HRs ranging from 1.1 to 21.5 for different types of cancer, metastatic vs localized cancer | 14 | |
| CATS study | Cohort | 740 | HR 2.0 (95% CI; 1.1-3.5) for (solid) tumor grade G3+G4 vs G1+G2 | 24 | |
| Time since cancer diagnosis | MEGA study | Case-control | 2131/3220 | OR 53.5 (95% CI; 8.6-334.3) in first 3 mo after cancer diagnosis | 10 |
| OR 14.3 (95% CI; 5.8-35.2) in 3-12 mo after cancer diagnosis | |||||
| OR 1.1 (95% CI; 0.6-2.2) > 15 y after cancer diagnosis | |||||
| Linkage of California Cancer Registry and California Discharge Dataset, colorectal cancer patients | Cohort | 68 142 | 5.0/100 PY 0-6 mo after cancer diagnosis 1.4/100 PY 6-12 mo after cancer diagnosis 0.6/100 PY 12-24 mo after cancer diagnosis | 25 | |
| Linked United Kingdom databases | Cohort | 82 203 | Median ratio 3.2 for VT risk in first 3 mo after diagnosis vs whole follow-up period, for cancer types separately | 13 | |
| Treatment | Olmsted county population | Nested case-control | 625/625 | OR 4.1 vs OR 6.5 for treatment with and without chemotherapy | 12 |
| Node-positive primary operable breast cancer patients | RCT | 353/352 | Cum. inc. of VT: 13.6% vs 2.6% for 2 y tamoxifen with vs without 6 mo additional chemotherapy | 33 | |
| Advanced gastroesophageal cancer patients | RCT | 490/474 | Cum. inc. of VT during and 30 days after chemotherapy: 12.2% for cisplatin vs 6.5% for oxaliplatin containing regimens | 34 | |
| 35 papers on trials with cancer patients | Meta-analysis | 6769 | RR 1.7 (95% CI; 1.4-2.1) for VT in cancer patients treated with red blood cell transfusions with vs without ESAs | 35 | |
| 38 papers on phase 3 trials with cancer patients | Meta-analysis | 8172 | RR 1.6 (95% CI; 1.3-1.9) for VT in cancer patients treated with red blood cell transfusions with vs without ESAs | 36 | |
| 15 Papers on trials with patients with solid tumors | Meta-analysis | 7956 | RR 1.3 (95% CI; 1.1-1.6) for VT in cancer patients treated with standard antineoplastic therapy with vs without bevacizumab | 37 | |
| Patient-related | Linkage of California Cancer Registry and California Discharge Dataset, colorectal cancer patients | Cohort | 68 142 | HR 2.0 (95% CI; 1.7-2.3) for 3 or more comorbid conditions vs no comorbidities HR 0.4 (95% CI; 0.3-0.5) for Asian/Pacific Islanders vs Caucasians | 25 |
| Discharge database of University Healthsystem Consortium | Cohort | 1 015 598 | ORs ranging from 1.4 to 1.8 for cancer patients with a comorbidity vs cancer patients without comorbidities | 18 | |
| OR 1.2 and 0.7 for patients with black and asian ethnicity respectively vs white | |||||
| MEGA study | Case-control | 2131/3220 | OR 2.2 (95% CI; 0.3-17.8) for VT in cancer patients with vs without factor V Leiden | 10 |
| Topic . | Study population . | Study design . | Number of patients . | Effect estimate . | Reference . |
|---|---|---|---|---|---|
| Proportion of cancer-associated VT cases | Olmsted county population | Nested case-control | 625/625 | 18% (PAR) | 5 |
| California Discharge DataSet | Cohort | 21 002 | 21% | 9 | |
| Worcester metropolitan area, outpatient setting | Cohort | 1399 | 29% | 8 | |
| RIETE Registry | Cohort | 35 539 | 17% | 4 | |
| Tromsø Study | Cohort | 462 | 23% | 3 | |
| RR of VT for cancer vs no cancer | MEGA study | Case-control | 2131/3220 | OR 6.7 (95% CI; 5.2-8.6) | 10 |
| Olmsted county population | Nested case-control | 625/625 | OR 4.1 (95% CI; 1.9-8.5) | 12 | |
| Linked United Kingdom databases | Cohort | 82 203/577 207 | HR 4.7 (95% CI; 4.5-4.9) | 13 | |
| Danish population-based registries | Cohort | 57 591/287 476 | HR 4.7 (95% CI; 4.3-5.1) | 11 | |
| Absolute risk of VT in cancer patients | Linkage of California Cancer Registry and California Discharge Dataset | Cohort | 235 149 | 1.6% within 2 y | 14 |
| Referred patients with solid tumors | Cohort | 1041 | 7.8% (median follow-up 26 mo) | 15 | |
| CATS study | Cohort | 840 | 8% within 1 y | 16 | |
| 38 papers on cohorts with cancer patients | Meta-analysis | NA | 13/1000 PY (95% CI; 7-23) for average-risk patients | 17 | |
| 68/1000 PY (95% CI; 48-96) for high-risk patients | 17 | ||||
| Linked United Kingdom databases | Cohort | 82 203 | 14/1000 PY (95% CI; 13-14) | 13 | |
| Incidence of VT in cancer patients over time | US National Hospital Discharge Survey | Cohort | 40 787 000 | 1.5% in 1989; 3.5% in 1999 | 19 |
| Discharge Database from University HealthSystem Consortium | Cohort | 1 015 598 | ∼3.5% in 1995; ∼4.5% in 2002 | 18 | |
| Linked United Kingdom databases | Cohort | 82 203 | 10.3/1000 PY in 1997; 19/1000 PY in 2006 | 13 | |
| Risk factors for VT in cancer patients | |||||
| Type of cancer | 38 papers on cohorts with cancer patients | Meta-analysis | NA | Pancreatic cancer: ∼110/1000 PY | 17 |
| Brain cancer: ∼80/1000 PY | |||||
| Lung cancer: ∼45/1000 PY | |||||
| Haematologic cancer: ∼40/1000 PY | |||||
| Colorectal cancer: ∼30/1000 PY | |||||
| Bone cancer: ∼30/1000 PY | |||||
| Prostate cancer: ∼10/1000 PY | |||||
| Breast cancer: ∼10/1000 PY | |||||
| Stage of cancer | Danish population-based registries | Cohort | 40 994/204 970 | HRs 2.9, 2.9, 7.5, and 17.1 for stage I, II, III, and IV cancer patients, respectively, vs general population | 11 |
| Linkage of California Cancer Registry and California Discharge Dataset | Cohort | 235 149 | HRs ranging from 1.1 to 21.5 for different types of cancer, metastatic vs localized cancer | 14 | |
| CATS study | Cohort | 740 | HR 2.0 (95% CI; 1.1-3.5) for (solid) tumor grade G3+G4 vs G1+G2 | 24 | |
| Time since cancer diagnosis | MEGA study | Case-control | 2131/3220 | OR 53.5 (95% CI; 8.6-334.3) in first 3 mo after cancer diagnosis | 10 |
| OR 14.3 (95% CI; 5.8-35.2) in 3-12 mo after cancer diagnosis | |||||
| OR 1.1 (95% CI; 0.6-2.2) > 15 y after cancer diagnosis | |||||
| Linkage of California Cancer Registry and California Discharge Dataset, colorectal cancer patients | Cohort | 68 142 | 5.0/100 PY 0-6 mo after cancer diagnosis 1.4/100 PY 6-12 mo after cancer diagnosis 0.6/100 PY 12-24 mo after cancer diagnosis | 25 | |
| Linked United Kingdom databases | Cohort | 82 203 | Median ratio 3.2 for VT risk in first 3 mo after diagnosis vs whole follow-up period, for cancer types separately | 13 | |
| Treatment | Olmsted county population | Nested case-control | 625/625 | OR 4.1 vs OR 6.5 for treatment with and without chemotherapy | 12 |
| Node-positive primary operable breast cancer patients | RCT | 353/352 | Cum. inc. of VT: 13.6% vs 2.6% for 2 y tamoxifen with vs without 6 mo additional chemotherapy | 33 | |
| Advanced gastroesophageal cancer patients | RCT | 490/474 | Cum. inc. of VT during and 30 days after chemotherapy: 12.2% for cisplatin vs 6.5% for oxaliplatin containing regimens | 34 | |
| 35 papers on trials with cancer patients | Meta-analysis | 6769 | RR 1.7 (95% CI; 1.4-2.1) for VT in cancer patients treated with red blood cell transfusions with vs without ESAs | 35 | |
| 38 papers on phase 3 trials with cancer patients | Meta-analysis | 8172 | RR 1.6 (95% CI; 1.3-1.9) for VT in cancer patients treated with red blood cell transfusions with vs without ESAs | 36 | |
| 15 Papers on trials with patients with solid tumors | Meta-analysis | 7956 | RR 1.3 (95% CI; 1.1-1.6) for VT in cancer patients treated with standard antineoplastic therapy with vs without bevacizumab | 37 | |
| Patient-related | Linkage of California Cancer Registry and California Discharge Dataset, colorectal cancer patients | Cohort | 68 142 | HR 2.0 (95% CI; 1.7-2.3) for 3 or more comorbid conditions vs no comorbidities HR 0.4 (95% CI; 0.3-0.5) for Asian/Pacific Islanders vs Caucasians | 25 |
| Discharge database of University Healthsystem Consortium | Cohort | 1 015 598 | ORs ranging from 1.4 to 1.8 for cancer patients with a comorbidity vs cancer patients without comorbidities | 18 | |
| OR 1.2 and 0.7 for patients with black and asian ethnicity respectively vs white | |||||
| MEGA study | Case-control | 2131/3220 | OR 2.2 (95% CI; 0.3-17.8) for VT in cancer patients with vs without factor V Leiden | 10 |
Cum. inc., cumulative incidence; NA, not applicable; PAR, population attributable risk; PY, person-years; RCT, randomized controlled trial; VT, venous thrombosis.