Skip to main content
ISTH 2024 Main banner
Back

Poster Networking

Venous Thromboembolism

PB1416 - Occult cancer in patients diagnosed with VTE: incidence and evaluation of diagnostic routines – data from the TROLL-registry

Tuesday, June 25, 2024
13:45 – 14:45 ICT
Room: Exhibition Hall

    Co-Author(s)

  • CC

    Camilla Corneliussen

    Medical student
    University of Oslo
    Stavanger, Rogaland, Norway

    • Co-Author(s)

  • Waleed Ghanima

    Head of Research and Consultant Hematologist
    Department of Medicine, Østfold Hospital Trust
    Kalnes, Ostfold, Norway

  • MT

    Mazdak Tavoly

    PhD, MD
    Department of Medicine, Sahlgrenska University Hospital
    Gothenburg, Vastra Gotaland, Sweden

    • Presenting Author(s)

  • Camilla Tøvik Jørgensen, RN, MSc

    Researcher PhD Student
    Department of Medicine, Østfold Hospital Trust
    Sarpsborg, Ostfold, Norway

    • Co-Author(s)

  • JG

    Jostein Gleditsch

    MD
    Department of Radiology, Østfold Hospital Trust
    Sarpsborg, Ostfold, Norway

Background: Venous thromboembolism (VTE) may signal an undiscovered cancer, detected in 3-6% of patients with unprovoked VTE. Screening for occult malignancy in this group is recommended. Yet the extent of screening remains a subject of debate.

Aims: To explore the prevalence of occult cancer after diagnosing VTE, to describe the most prevalent cancer sites, and to evaluate the diagnostic yield of the performed screening tests.

Methods: Collected data from the Venous thromboembolism registry at Østfold Hospital, Norway (TROLL registry), included patients ≥18 years diagnosed with a first episode of VTE between 2005 and 2020. Occult cancer was defined as confirmed cancer diagnosis within three months from the VTE diagnosis date.

Results: Median age of the 3411 identified patients was 66 years (IQR:53-78); 48.4% were women. Cancer screening was conducted in 1784 patients (52.3%). Occult cancer was diagnosed in 5.6% of first-time VTE cases with 7.1% in unprovoked and 3.1% in provoked VTE. Patients with occult cancer had a median age of 71 years (IQR:63-79), with 50.5% being women. The most frequent malignancies were respiratory organ cancer (21.6%), colorectal (13.7%), urinary tract (10.0%), and prostate (8.4%). The table shows the frequency of tests and their diagnostic yield. Chest X-ray was indicative of malignancy in 0.5%. The positivity rates for other tests ranged from 4.7% to 32%. 27% of patients examined by abdominal US had to undergo CT abdomen. 1-year mortality was 11.5% in the cancer screening group and 10.8% in patients with no screening.

Conclusion(s): The prevalence of occult cancer in the TROLL registry is in line with other studies. Cancer was also diagnosed in 3.1% of patients with provoked VTE . Lack of information on clinical suspicions of underlying malignancy is a limitation. The diagnostic yield of some tests was limited indicating that the diagnostic work-up needs to be reassessed.