Thrombosis as a harbinger of cancer.
OBJECTIVE
The aim of this review is to explore the state of the art knowledge on the possible association between venous thromboembolism, especially idiopathic venous thromboembolism, and occult cancer, and to speculate on its implications.


RESULTS
Venous thromboembolism, especially idiopathic venous thromboembolism, is sometimes associated with a subsequent increased risk of newly discovered cancers during the follow-up period. Its incidence approximates 10%. The performance of extensive screening procedures for cancer identification when venous thromboembolism is diagnosed appears advisable if it provides an impact on cancer-related mortality. Recent prospective trials have observed that, thanks to extensive screening procedures, most hidden cancers are detected at baseline or at an earlier stage. Data from these studies do not conclusively demonstrate that earlier diagnosis ultimately prolongs life, but the collective observation makes such a beneficial effect likely.


CONCLUSIONS
Venous thromboembolism, especially in its idiopathic presentation, may sometimes be a marker for a hidden cancer. With extensive screening procedures, the earlier discovery of cancer, which might mean identification of the disease at an attachable stage, may be crucial, because innovations in treatment protocols provide increasing chances of success and the eradication of cancer.
Prandoni
Paolo
P
Department of Medical and Surgical Sciences, University of Padua, Padua, Italy. paoloprandoni@tin.it
Piccioli
Andrea
A
D006801:Humans; D009369:Neoplasms / Q000097:blood / Q000150:complications*; D011379:Prognosis; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013923:Thromboembolism / Q000209:etiology*; D020246:Venous Thrombosis / Q000209:etiology*