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Screening for Occult Cancer in Patients with Venous Thromboembolism
Julien D'Astous1, Marc Carrier2
1Department of Medicine, Centre Hospitalier de l'Université de Montréal, Université de Montréal, 1000 Saint-Denis Street, Montréal, QC H2X 0C1, Canada.
Journal of Clinical Medicine
|July 31, 2020
Summary
Unprovoked venous thromboembolism (VTE) may signal hidden cancer. While screening is appealing, extensive occult cancer screening in VTE patients is not recommended due to lack of proven benefits.
Area of Science:
- Oncology
- Hematology
- Internal Medicine
Background:
- Unprovoked venous thromboembolism (VTE) is a potential indicator of occult cancer.
- Approximately 5% of VTE patients are diagnosed with cancer within 12 months.
- Screening for occult cancer in VTE patients is considered to potentially improve outcomes.
Purpose of the Study:
- To review the epidemiology, timing, and evidence for occult cancer detection in patients with unprovoked VTE.
- To evaluate the utility of various cancer screening strategies in this patient population.
Main Methods:
- This narrative review synthesizes evidence from randomized controlled trials and clinical guidance documents.
- Focuses on the diagnostic yield and impact of different screening approaches.
Main Results:
- Extensive occult cancer screening strategies (e.g., CT scans) have not demonstrated improvement in patient-important outcomes.
- Limited screening (history, physical, basic labs, chest X-ray, age/gender-specific screening) is currently recommended.
Conclusions:
- Intensive occult cancer screening beyond limited strategies is not routinely advised for unprovoked VTE patients.
- Current evidence does not support widespread, advanced screening protocols for detecting cancer in VTE patients.
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