Prospective cohort study of cancer patients diagnosed with incidental venous thromboembolism on routine computed tomography scans.

Abstract

Venous thromboembolism (VTE) is a major complication of cancer with recent increasing reports of incidental VTE. The objectives are to estimate the prevalence of incidental VTE in cancer patients on staging CT scans, identify common symptoms, and determine VTE recurrence in a prospective study. One thousand ninety patients were studied. Adult cancer patients scheduled for outpatient staging CT scans were eligible. VTE cases were followed for 6months. Fisher's exact test for group comparisons of categorical variables and generalized linear modeling to estimate the prevalence of incidental VTE was used. The mean age was 58years (range 18-87years); 50% were male. The prevalence of incidental VTE was 1.8% (CI 1.15-2.87%). Significant symptoms in patients with VTE included fatigue (p=0.004), stress (p=0.0195), depression (p=0.019), poorer quality of life (p=0.0194), and poorer physical well-being (p=0.0007). All the patients with VTE had at least one comorbidity (p=0.03). No patient had recurrence within 6months. The prevalence of incidental VTE on staging CT scans is lower than previously reported. Symptoms were associated with VTE; however, further work is needed to understand whether these are clinically relevant. No VTE recurrences were noted following 6months.