The Risk of Cancer Following Acute Venous Thromboembolism: A Population-Based Cohort Study
Notice bibliographique
Résumé
Abstract Abstract 3399 Introduction: Current estimates of cancer risk following acute venous thromboembolism (VTE) vary widely, are based largely on studies with select populations and often include prevalent cancer cases. Objectives: We aimed to determine the incidence and standardized incidence ratio (SIR) of cancer following VTE in a large non-select population. Secondary objectives were to determine time to incident cancer, type of cancer and predictors of cancer. Methods: This retrospective, observational study used the linked administrative healthcare databases of the province of Quebec, Canada, including the province-wide hospitalization database Maintenance et exploitation des données pour l'étude de la clientèle hospitalière (MED-ÉCHO), the vital statistics database of the Institut de la statistique du Québec, and the healthcare services database of the Régie de l'assurance maladie (RAMQ) which is a governmental agency that administers the Quebec universal healthcare program and oversees all physician reimbursement claims. We identified a cohort of patients with a first hospital diagnosis of acute VTE between January 1st, 1994 and December 31, 2004, without a cancer diagnosis in the 24 months prior to the VTE, and who were followed for a minimum of one year until the earliest of either a diagnosis of cancer, occurrence of death, or end of study (December 31st, 2005). Subjects with prevalent cancer (diagnosed within 3 months after VTE) were excluded. VTE cases were classified as unprovoked vs. provoked based on the presence of VTE risk factors in the three months preceding the VTE diagnosis. We determined annual incidence rates of cancer and associated 95% confidence intervals (CI) by dividing the number of cancer cases by the total person-years at risk. Canadian Cancer statistics for the years 1994–2005 were used to calculate the SIRs. Results: Among 39 222 patients with first-time VTE and without a diagnosis of cancer in the previous 24 months, 3 062 (7.8%) were diagnosed with cancer during a mean follow-up of 65.2 months [standard deviation (SD) =39.1], for an annual incidence rate of 1.55 (95% CI 1.49–1.60) per 100 person-years. Mean time to cancer diagnosis following VTE was 40.5 months (SD=32.3). Gastrointestinal (25.7%), genitourinary (25.7%) and pulmonary (19.6%) malignancies were most frequent. The SIR for any cancer was 3.55 (95% CI 3.43–3.68). Table 1 shows the SIRs by cancer type. Clinical predictors for cancer were male sex [hazard ratio (HR) 1.59 (95% CI 1.49–1.72)], increasing age [HR 1.53 (95% CI 1.49–1.57)] and increasing comorbidity [HR 1.04 (95% CI 1.01–1.06)]. The annual risk for cancer was 1.7 times higher in patients with provoked compared to patients with unprovoked VTE [1.94 (95% CI 1.86–2.03) vs. 1.15 (95% CI 1.09–1.22) per 100 person-years, respectively]. Compared to patients with unprovoked VTE, patients with provoked VTE were older [61.9 mean years (SD=18.3) vs. 56.6 mean years (SD=18.4); p<0.001] and had a higher Charlson comorbidity index weighted score [1.19 (SD=1.57) vs. 0.62 (SD=1.12); p<0.001]. Conclusion: In patients with acute VTE and without previous or prevalent cancer, the annual risk of cancer is 1.55%, which is higher than the risk in the general population. The mean time to cancer diagnosis is about 3.4 years. Male sex, advanced age, and increasing comorbid conditions are associated with a diagnosis of cancer. Advanced age and a higher burden of comorbid conditions may explain the higher incidence of cancer observed in patients with provoked VTE compared to patients with unprovoked VTE. Clinicians should be aware of the associated long-term risk of cancer in patients presenting with acute VTE. Disclosures: No relevant conflicts of interest to declare.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».