Survival after Cancer-related Venous Thrombosis: The Scandinavian Thrombosis and Cancer Study (STAC)

M.J.T. Crobach^1,2, R.J.S. Anijs^1,3, S.K. Brækken^4,5, M.T. Severinsen⁶, J. Hammerstrøm⁷, H. Skille^4,5, S.R. Kristensen⁶, B. Paulsen^4,5, A. Tjønneland⁸, H.H. Versteeg¹, K. Overvad^9,10, J.-B. Hansen^4,5, I.A. Næss¹¹, S.C. Cannegieter^1,3

¹Leiden University Medical Center, Department of Internal Medicine, Leiden, the Netherlands, ²Leiden University Medical Center, Department of Medical Microbiology, Leiden, the Netherlands, ³Leiden University Medical Center, Department of Clinical Epidemiology, Leiden, the Netherlands, ⁴The Artic University of Norway, K.G Jebsen Thrombosis Research and Expertise Centre (TREC), Department of Clinical Medicine, Tromso, Norway, ⁵University Hospital of North Norway, Division of Internal Medicine, Tromso, Norway, ⁶Aalborg University Hospital, Aalborg, Denmark, ⁷Norwegian University of Science and Technology, Department of Cancer Research and Molecular Medicine, Trondheim, Norway, ⁸Danish Cancer Society Research Center, Diet, Genes and Environment, Copenhagen, Denmark, ⁹Aarhus University, Department of Public Health, Section for Epidemiology, Aarhus, Denmark, ¹⁰Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark, ¹¹Trondheim University Hospital, Department of Hematology, Trondheim, Norway

Abstract Number: PB2103

Meeting: ISTH 2020 Congress

Theme: Venous Thromboembolism and Cardioembolism » Cancer Associated Thrombosis

Background: Cancer patients have an increased risk of developing a venous thromboembolism (VTE) and this combination is reported to result in poorer survival compared to cancer alone.

Aims: To investigate the impact of VTE on the survival of cancer patients in a general population.

Methods: The Scandinavian Thrombosis and Cancer (STAC) cohort, a population-based cohort including 144,952 subjects without previous VTE or cancer was used. During follow-up, cancer and VTE incidences were registered. ‘Cancer-related VTE’ was defined as VTE diagnosed in patients with overt or occult cancer. Survival of subjects without cancer or VTE (‘disease-free subjects’) was compared with survival of subjects diagnosed with cancer and cancer-related VTE. Cox-regression models with cancer and VTE as time-varying exposures were performed to calculate hazard ratios for death. Sub-analyses were performed across different cancer types and stages.

Results: During follow-up (mean 11.7 years) 14,621 subjects developed cancer and 2,444 developed VTE, of which 1241 where cancer-related. The mortality rates (per 100 person-years) for disease-free subjects, VTE only, cancer only and cancer-related VTE were 0.63 (95% CI 0.62-0.65), 5.0 (95% CI 4.6-5.5), 9.2 (95% CI 9.0-9.5) and 45.3 (95% CI 41.1-50.0), respectively. Compared with cancer patients, the risk of death for cancer-related VTE patients was increased 3.4-fold (95% CI 3.1-3.8). Among all cancer types, the occurrence of a VTE increased the mortality risk 2.8 to 14.7-fold.

Conclusions: In a general population, cancer patients with a VTE had a 3.4-fold increased mortality risk compared to cancer patients without VTE, this effect was seen within all cancer types and stages studied.

To cite this abstract in AMA style:

Crobach MJT, Anijs RJS, Brækken SK, Severinsen MT, Hammerstrøm J, Skille H, Kristensen SR, Paulsen B, Tjønneland A, Versteeg HH, Overvad K, Hansen J-, Næss IA, Cannegieter SC. Survival after Cancer-related Venous Thrombosis: The Scandinavian Thrombosis and Cancer Study (STAC) [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/survival-after-cancer-related-venous-thrombosis-the-scandinavian-thrombosis-and-cancer-study-stac/. Accessed November 30, 2021.

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