title: Incidence of venous thromboembolism and its effect on survival among patients with common cancers.
abstract: BACKGROUND
  The incidence of venous thromboembolism after diagnosis of specific cancers and the effect of thromboembolism on survival are not well defined.
  
  
  METHODS
  The California Cancer Registry was linked to the California Patient Discharge Data Set to determine the incidence of venous thromboembolism among cancer cases diagnosed between 1993 and 1995. The incidence and timing of thromboembolism within 1 and 2 years of cancer diagnosis and the risk factors associated with thromboembolism and death were determined.
  
  
  RESULTS
  Among 235 149 cancer cases, 3775 (1.6%) were diagnosed with venous thromboembolism within 2 years, 463 (12%) at the time cancer was diagnosed and 3312 (88%) subsequently. In risk-adjusted models, metastatic disease at the time of diagnosis was the strongest predictor of thromboembolism. Expressed as events per 100 patient-years, the highest incidence of thromboembolism occurred during the first year of follow-up among cases with metastatic-stage pancreatic (20.0), stomach (10.7), bladder (7.9), uterine (6.4), renal (6.0), and lung (5.0) cancer. Adjusting for age, race, and stage, diagnosis of thromboembolism was a significant predictor of decreased survival during the first year for all cancer types (hazard ratios, 1.6-4.2; P<.01).
  
  
  CONCLUSIONS
  The incidence of venous thromboembolism varied with cancer type and was highest among patients initially diagnosed with metastatic-stage disease. The incidence rate of thromboembolism decreased over time. Diagnosis of thromboembolism during the first year of follow-up was a significant predictor of death for most cancer types and stages analyzed. For some types of cancer, the incidence of thromboembolism was sufficiently high to warrant prospective clinical trials of primary thromboprophylaxis.
authors.affiliation: Divisionsof Hematology/Oncology, Department of Internal Medicine, and Department of Public Health Sciences, University of California, Davis, Sacramento, CA 95817, USA. helen.chew@ucdmc.ucdavis.edu
authors.forename: Helen K
authors.initials: HK
authors.lastname: Chew
authors.forename: Theodore
authors.initials: T
authors.lastname: Wun
authors.forename: Danielle
authors.initials: D
authors.lastname: Harvey
authors.forename: Hong
authors.initials: H
authors.lastname: Zhou
authors.forename: Richard H
authors.initials: RH
authors.lastname: White
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications* / Q000401:mortality*; D015996:Survival Rate; D013923:Thromboembolism / Q000453:epidemiology* / Q000209:etiology*