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Publication Abstract

Authors: Marks MA, Engels EA

Title: Venous Thromboembolism and Cancer Risk among Elderly Adults in the U.S.

Journal: Cancer Epidemiol Biomarkers Prev :-

Date: 2014 Mar 08

Abstract: Background: Few studies have evaluated cancer risk following venous thromboembolism (VTE). Both VTE and cancer disproportionately affect older adults. Methods: Using linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we evaluated 1.2 million cancer cases and 200,000 controls (66-99 years old, 1992-2005). VTEs occurring before selection were identified using Medicare claims. Logistic regression was used to estimate odds ratios (ORs). Results: VTE was present in 2.5% of cases and 2.2% of controls. VTE was associated with risk of cancers of the lung (OR 1.18, 95%CI 1.12-1.23), stomach (1.19, 1.09-1.30), small intestine (1.42, 1.17-1.71), colon (1.25, 1.18-1.31), gallbladder (1.39, 1.16-1.67), pancreas (1.53, 1.43-1.64), soft tissue (1.43, 1.21-1.68), ovary (1.35, 1.22-1.50), and kidney/renal pelvis (1.34, 1.23-1.46), and melanoma (1.17, 1.08- 1.27), non-Hodgkin lymphoma (1.27, 1.20- 1.35), myeloma (1.48, 1.35-1.63), and acute myeloid leukemia (1.35, 1.19-1.54). Strongest risks were observed within 1 year of VTE diagnosis, but risk were elevated more than 6 years after VTE for colon cancer (OR 1.24, 95%CI 1.12-1.37), pancreatic cancer (1.33, 1.15-1.54), and myeloma (1.35, 1.10-1.66). Few differences in risk were observed by VTE subtype. Cancers of the lung, stomach, and pancreas were more likely to have distant metastases within one year after VTE. Conclusion: Among elderly adults, cancer risk is elevated following VTE diagnosis. Impact: Short-term associations with cancer are likely driven by enhanced screening following VTE and reverse causation. While obesity, other co-morbidities, and smoking cannot be excluded as explanations, longer-term elevations for select cancers suggest that some VTEs may be caused by cancer precursors.

Last Modified: 03 Sep 2013