Occult cancer detection in venous thromboembolism: the past, the present, and the future

Res Pract Thromb Haemost. 2017 Jun 16;1(1):9-13. doi: 10.1002/rth2.12007. eCollection 2017 Jul.

Abstract

Unprovoked venous thromboembolism (VTE) can be the first manifestation of an undiagnosed cancer. Recently published studies have suggested that approximately 4-5% of patients with new unprovoked VTE will be diagnosed with cancer within 12 months of follow-up. Therefore, it is important for clinicians to keep a low threshold of suspicion for occult cancer in this patient population. After an unprovoked VTE diagnosis, patients should undergo a thorough medical history, physical examination, basic laboratory investigations (ie, complete blood count and liver function tests), chest X-ray, as well as age- and gender-specific cancer screening (breast, cervical, colon, and prostate). More intensive cancer screening including additional investigations (eg, computed tomography of the abdomen/pelvis) does not seem to increase the rate of occult cancer detection, decrease cancer-related morbidity, or increase survival or cost-effectiveness.

Keywords: early detection screening; neoplasm; tomography; venous thromboembolism; venous thrombosis.

Publication types

  • Review