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Epidemiology of Venous Thromboembolism After Second Cancer

Authors Gade IL, Severinsen MT, Kragholm KH, Kristensen SR, Torp-Pedersen C, Riddersholm SJ

Received 31 January 2020

Accepted for publication 14 March 2020

Published 8 April 2020 Volume 2020:12 Pages 377—386


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Henrik Toft Sørensen

Inger Lise Gade,1,2 Marianne Tang Severinsen,2,3 Kristian Hay Kragholm,4,5 Søren Risom Kristensen,1,3 Christian Torp-Pedersen,3,5,6 Signe Juul Riddersholm7

1Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark; 2Department of Hematology and Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark; 3Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; 4Department of Cardiology, North Denmark Regional Hospital, Hjørring, Denmark; 5Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark; 6Department of Cardiology and Clinical Investigation, North Zealand Hospital, Hillerød, Denmark; 7Department of Medicine, Randers Regional Hospital, Randers, Denmark

Correspondence: Inger Lise Gade
Department of Hematology, Aalborg University Hospital, Mølleparkvej 4, Aalborg 9000, Denmark
Tel +45 61656584

Background: Venous thromboembolism (VTE) is a serious, yet preventable, complication in cancer. Some patients are diagnosed with a second cancer; however, little is known about the epidemiology of VTE in this population.
Methods: From Danish national healthcare registries, we studied all patients diagnosed with a first breast, prostate, lung, or colorectal cancer from 1995 to 2015. We estimated incidence rates (IRs) of VTE according to the timing of the diagnosis of a second cancer. We controlled for confounder variables in Poisson regression models.
Results: In total, 309,077 patients with a first breast, prostate, lung, or colorectal cancer were included in the study. A second cancer was diagnosed in 20,090 (6.5%) of these patients. In total, 11,908 VTEs were observed in the study period, 786 of these occurred after a diagnosis of second cancer. Second cancer types such as pancreas and stomach cancer were associated with fivefold higher IRs of VTE compared with second cancer types such as breast and prostate cancer. The IR of VTE was highest within the first 6 months after the second cancer was diagnosed (IR 40.5 per 1000 person-years, 95% CI 36.3– 42.2) with no differences based on how long since the first cancer it was diagnosed.
Conclusion: The epidemiology of VTE after a second cancer is similar to the epidemiology of VTE after a first cancer with higher rates within the first months after aggressive second cancer types.

Keywords: venous thromboembolism, second cancer, epidemiology, incidence, cancer

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