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

M.J.T. Crobach1,2, R.J.S. Anijs1,3, S.K. Brækken4,5, M.T. Severinsen6, J. Hammerstrøm7, H. Skille4,5, S.R. Kristensen6, B. Paulsen4,5, A. Tjønneland8, H.H. Versteeg1, K. Overvad9,10, J.-B. Hansen4,5, I.A. Næss11, S.C. Cannegieter1,3

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 September 29, 2023.

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