Screening for Occult Cancer in Unprovoked Venous Thromboembolism

Screening for Occult Cancer in Unprovoked Venous Thromboembolism. N Engl J Med. 2015 Aug 20;373(8):697-704.

Carrier M(1), Lazo-Langner A, Shivakumar S, Tagalakis V, Zarychanski R, Solymoss S, Routhier N, Douketis J, Danovitch K, Lee AY, Le Gal G, Wells PS, Corsi DJ, Ramsay T, Coyle D, Chagnon I, Kassam Z, Tao H, Rodger MA; SOME Investigators.

Collaborators: Carrier M, Castellucci L, Code C, Corsi DJ, Coyle D, Danovitch K, Le Gal G, Forgie M, Gandara E, Gonsalves C, Karovitch A, Pecarskie A, Ramsay T, Rodger MA, Scarvelis D, Tao H, Wells PS, Corpuz R, Kassam Z, Lazo-Langner A, Taves D, Anderson DR, Couban S, Hasegawa W, Keating M, Kew A, Macdonald D, Robinson KS, White D, Shivakumar S, Zarychanski R, Wong T, Blostein M, Chagnon I, Hirsch A, Kahn S, Routhier N, Solymoss S, Tagalakis V, Douketis J, Lee AY.

(1)From the Department of Medicine (M.C., K.D., G.L.G., P.S.W., M.A.R.) and the Clinical Epidemiology Program (D.J.C., T.R., D.C.), Ottawa Hospital Research Institute, and Department of Diagnostic Imaging (H.T.), University of Ottawa, Ottawa, Departments of Medicine (A.L.-L.), Oncology (A.L.-L.), Epidemiology and Biostatistics (A.L.-L.), and Medical Imaging (Z.K.), University of Western Ontario, London, Department of Medicine, Dalhousie University, Halifax, NS (S. Shivakumar), Department of Medicine, Jewish General Hospital (V.T.), and Department of Medicine, Montreal General Hospital (S. Solymoss), McGill University, and Department of Medicine, Sacre Coeur Hospital, Université de Montréal (N.R., I.C.), Montreal, Department of Medicine, University of Manitoba, Winnipeg (R.Z.), Department of Medicine, McMaster University, Hamilton, ON (J.D.), and the Department of Medicine, University of British Columbia, Vancouver (A.Y.L.) - all in Canada.

Venous thromboembolism may be the earliest sign of cancer. Currently, there is a great diversity in practices regarding screening for occult cancer in a person who has an unprovoked venous thromboembolism. This study assessed the efficacy of a screening strategy for occult cancer that included comprehensive computed tomography (CT) of the abdomen and pelvis in patients who had a first unprovoked venous thromboembolism.
The prevalence of occult cancer was low among patients with a first unprovoked venous thromboembolism. Routine screening with CT of the abdomen and pelvis did not provide a clinically significant benefit.

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