A10
Cancer patients with VTE have a distinct thrombosis risk factor profile compared with cancer-free patients with VTE
Peter Rose1, Shankaranarayana Paneesha2, Aidan McManus3, Roopen Arya4, Timothy Farren5, Nicholas Scriven6, Tim Nokes7, Sue Bacon8, Anthea Nieland9, Harry Smith10, Denise O'Shaughnessy11
1Warwick Hospital, Warwick, UK, 2Heart of England NHS Foundation Trust, Birmingham, UK, 3MMRx Consulting, London, UK, 4King's College Hospital, London, UK, 5Barts and The London Hospitals, London, UK, 6The Calderdale Royal Hospital, Halifax, UK, 7Derriford Hospital, Plymouth, UK, 8Scarborough Hospital, Scarborough, UK, 9Northampton General Hospital NHS Trust, Northampton, UK, 10sanofi-aventis, Guildford, UK, 11Department of Health, London, UK
Background
The association between venous thromboembolism (VTE) and cancer is well-recognised, but the thrombosis risk factor profile of patients with cancer-associated VTE is poorly characterised; it is unknown if there are differences with cancer-free VTE patients. Our aim was to compare the risk factor profiles of cancer and non-cancer patients with VTE enrolled in VERITY, an ongoing UK prospective VTE registry.
Method
Of 49044 case entries, cancer and VTE status were known in 41270. In total, 10518 (25.5%) had VTE. Of these, 1425 (13.5%) had cancer and 9093 (86.5%) were cancer-free. The presence of 7 established risk factors for VTE was compared in the cancer and cancer-free groups.
Results
Cancer patients with VTE were more likely to have the following risk factors:medical illness (medical in-patient history or immobilisation >3 days within last 4 weeks)(14.6% vs. 10.3%, χ2(1,N=10208)=14.9, p=0.0001); surgery (major surgery in the last 4 weeks)(25.2% vs. 10.3%, χ2 (1,N=11069)=162.2, p<0.0001); and hormonal risk factor (use of hormone-replacement therapy, oral contraceptives, pregnant or post-partum)(26.8% vs. 15.6%; χ2 (1,N=11203)=61.1, p<0.0001). Cancer-free patients with VTE were more likely to have the following risk factors: previous history of VTE (28.3% vs. 18.2%, χ2 (1,N=12401)=33.8, p<0.0001); known thrombophilia (2.2% vs. 1%, χ2 (1,N=9678)=6.8, p=0.0089); intravenous drug abuse (8.2% vs. 0.5%, χ2 (1,N=10207)=84.6, p<0.0001); and smoking (current smoker)(26.9% vs. 14.2%, χ2 (1,N=10315)=48.2, p<0.0001).
Conclusion
Cancer and non-cancer patients with VTE have distinct thrombosis risk factor profiles. Previous history of VTE, known thrombophilia, intravenous drug abuse and smoking were significantly more common in the cancer-free thrombosis group. These findings have implications for risk algorithms for VTE prevention.
