Background: Cancer is a well-known risk factor for VTE. Data is presented on various metrics, for patients with VTE in the context of underlying Cancers.

Aims: Identify all VTE events diagnosed between 2015 and 2019 (5 years), associated with active cancer as a risk factor. Assess trends in management over the study period including anticoagulation use.

Methods: All VTE events identified from targeted radiological data, comprising CT pulmonary angiograms. SPECT-CT and Doppler ultrasounds of upper and lower limbs, were reviewed for evidence of active cancer as a risk factor. Cancer type and degree of metastasis was also assessed, together with anticoagulant used and duration

Results: A total of 4116 VTE events occurred over five years. 936 (23%) of these had active cancer as a risk factor. Of the 3210 community-acquired (CAT) events, 609 (19%) were cancer-associated, compared to 327 of the 906 hospital acquired (HAT) events (36%). Overall 174/936 (19%) demonstrated metastatic cancer. The most prevalent cancers were lung, prostate, breast and bowel, comprising 56% of all cancers associated with VTE. Low molecular weight heparin (LMWH) was the most widely prescribed treatment in 66% of cases, followed by Rivaroxaban at 23% and Apixaban at 6%. The use of direct oral anticoagulants generally, has increased significantly over the last two years.

Conclusions: Cancer is a major risk factor for VTE. Using the UK Department of Health, VTE risk assessment tool, only age (>60 years) demonstrated a larger risk within our VTE outcome data. The most common cancers identified are not those known to have the highest VTE risk, but are the more prevalent cancers, therefore explaining this outcome. Understandably, acknowledging current national guidance, LMWH is by far the most common anticoagulant used in the cancer risk cohort. This is likely to change soon.

[Venous Thromboembolism events associated with cancer 2015 – 2019]

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/venous-thromboembolism-vte-events-with-cancer-as-a-risk-factor-in-a-teaching-hospital-2015-2019/