Study Observes an Increased Risk in Thromboembolic Events 30 Days Prior to Cancer Diagnosis

A study published in Blood observed an increased risk of arterial thromboembolic events—including myocardial infarction and stroke—5 months prior to a cancer diagnosis.

Researchers assessed the Surveillance Epidemiology and End Results–Medicare dataset to identify 374,331 patients with cancer who were 67 years or older with a new primary diagnosis of breast, lung, prostate, colorectal, bladder, uterine, pancreatic, gastric cancer, or non-Hodgkin lymphoma between 2005 and 2013.

Patients with cancer are not only at higher risk of venous events: "Arterial thromboembolic events preceding the diagnosis of cancer in older persons" https://t.co/IBWVYOcRcK https://t.co/SZQNNV3JhZ

— Scott Tagawa (@DrScottTagawa) December 21, 2018

Patients were then matched to individual controls without cancer based on year of birth, sex, race, and the presence of some other comorbidities, for a final participant total of 748,662.

Researchers used the Mantel-Haenszel estimator to compare risks of arterial thromboembolic events between the cancer and non-cancer groups during 30-day periods in the 360 days before date of cancer diagnosis.

From 360 to 151 days before cancer diagnosis, the 30-day interval risks of arterial thromboembolic events were similar between patients with cancer and matched controls. However, from 150 to 1 day before a cancer diagnosis, the interval 30-day risks of arterial thromboembolic events were higher in patients with cancer, and this progressively increased as the cancer diagnosis date approached, peaking during the 30-days immediately before cancer diagnosis.

The risk of heart attack or stroke is increased by 70% in the 12 months and 500% in the 1 month before a cancer dx, highest in adults with lung and colorectal cancers and those with stage 3 or 4 disease. OMG! https://t.co/O0TLNEVg6P

— Craig Hofmeister (@EagleMyeloma) December 21, 2018

At 30 days prior to diagnosis, the risk of developing an arterial thromboembolic event was more than 5.5-fold higher in the cancer cohort compared with the control group (P<0.001). Specifically, 2,313 (0.62%) patients with cancer were diagnosed with an arterial thromboembolic event compared with 413 (0.11%) controls (odds ratio = 5.63; 95% CI, 5.07-6.25).

During the 360 days prior to a cancer diagnosis, the risk of developing an arterial thromboembolic event was 69% higher among those who were later diagnosed with cancer compared with controls (1.75% vs 1.05%; P<0.001).

The highest risk of an arterial thromboembolic event in the 360 days preceding their diagnosis occurred in patients diagnosed with lung cancer, followed by colorectal cancer.

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Source: Blood