WHAT WAS LEARNED?
The researchers found the12-month period prevalence of cancer after VTE diagnosis was 5.2% (range, 4.1% to 6.5%). The prevalence of cancer was higher in those who had extensive screening than in patients who had more limited initial screening. However, that was not the case at 12 months. The study also showed that cancer prevalence increased linearly with age. Prevalence was sevenfold higher in patients aged 50 years or older than in younger patients (odds ratio [OR], 7.1). The study showed that individual extensive screening tests, including CT of the abdomen and whole-body PET-CT, were not associated with a clear increase in detection of early stage cancers.
“The risk of cancer is much lower than we thought and so we don’t need to do more screening. Additional screening does not appear to provide a survival benefit,” Dr Carrier said in an interview with Oncology Nurse Advisor.
The study demonstrated there is a lack of a clear benefit and the potential harms of extensive screening are uncertain. The authors recommend a more limited occult cancer screening strategy. This includes taking a medical history, conducting a physical examination, and obtaining basic blood work chest radiography. “We know that we need to take a good history and do a physical exam in patients with venous thromboembolism. We also need to make sure that they have had age and sex appropriate screening tests for cancer,” said Colleen Morton, MD, who is at chief of Classical Hematology and an assistant professor of medicine at Vanderbilt University Medical Center (VUMC), Nashville, Tennessee.
She said these findings are important and may help better guide clinicians. “What we don’t know is if we need to subject all patients to extensive screening, like CT and PET scans, as studies have not demonstrated an improvement in outcomes. Extensive screening exposes the patient to radiation and there may be false positive results, leading to additional tests and emotional stress,” Dr Morton told Oncology Nurse Advisor.