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[Occult cancer and pulmonary embolism]
Philippe Debourdeau1, Dominique Farge-Bancel
1Service de médecine interne oncologie, hôpital Desgenettes 108, boulevard Pinel 69275 Lyon. pdebourdeau@yahoo.fr
La Revue Du Praticien
|July 14, 2007
Summary
Patients with venous thromboembolism (VTE) have a 5% standardized cancer incidence, particularly those with idiopathic, recurrent, or bilateral VTE. Early cancer diagnosis after VTE is crucial, as many present as advanced metastatic disease.
Area of Science:
- Oncology
- Hematology
- Clinical Medicine
Context:
- Venous thromboembolism (VTE) affects approximately 5% of patients with cancer.
- Risk factors for VTE-associated cancer include idiopathic, bilateral, or recurrent VTE.
- Cancer incidence peaks within the first year post-VTE, with 40% diagnosed at a metastatic stage.
Purpose:
- To investigate the association between venous thromboembolism (VTE) and cancer incidence.
- To identify specific VTE characteristics and cancer types associated with increased risk.
- To evaluate the cost-effectiveness of diagnostic work-ups and guide cancer screening strategies in VTE patients.
Summary:
- A 5% standardized cancer incidence is observed in patients with venous thromboembolism (VTE).
- Idiopathic, bilateral, or recurrent VTE increases cancer risk, with diagnosis often occurring within the first year post-VTE, frequently at a metastatic stage.
- Common malignancies presenting with VTE include pancreatic, stomach, ovarian, lung, brain, and liver cancers. Extensive diagnostic work-ups are not universally cost-effective; screening should be guided by clinical findings.
Impact:
- Highlights the significant comorbidity of VTE and cancer, emphasizing the need for vigilance.
- Informs clinical practice by suggesting targeted cancer screening based on patient presentation and VTE characteristics.
- Discourages routine, extensive diagnostic work-ups for all VTE patients, promoting a cost-effective and evidence-based approach to cancer detection.
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