title: Venous thromboembolism and subsequent risk of cancer in patients with liver disease: a population-based cohort study.
abstract: OBJECTIVE
  Venous thromboembolism (VTE) may be a marker of occult cancer in the general population. While liver disease is known to increase the risk of VTE and cancer, it is unclear whether VTE in patients with liver disease is also a marker of occult cancer.
  
  
  METHODS
  A population-based cohort study.
  
  
  METHODS
  Denmark.
  
  
  METHODS
  We used population-based health registries to identify all patients with liver disease in Denmark with a first-time diagnosis of VTE (including superficial or deep venous thrombosis and pulmonary embolism) during 1980-2010. Patients with non-cirrhotic liver disease and patients with liver cirrhosis were followed as two separate cohorts from the date of their VTE.
  
  
  METHODS
  For each cohort, we computed the absolute and relative risk (standardised incidence ratio; SIR) of cancer after VTE.
  
  
  RESULTS
  During the study period, 1867 patients with non-cirrhotic liver disease and 888 with liver cirrhosis were diagnosed with incident VTE. In the first year following VTE, the absolute risk of cancer was 2.7% among patients with non-cirrhotic liver disease and 4.3% among those with liver cirrhosis. The SIR for the first 90 days of follow-up was 9.96 (95% CI 6.85 to 13.99) among patients with non-cirrhotic liver disease and 13.11 (95% CI 8.31 to 19.67) among patients with liver cirrhosis. After 1 year of follow-up, SIRs declined, but remained elevated in patients with non-cirrhotic liver disease (SIR=1.50, 95% CI 1.23 to 1.81) and patients with liver cirrhosis (SIR=1.95, 95% CI 1.45 to 2.57).
  
  
  CONCLUSIONS
  VTE may be a marker of occult cancer in patients with liver disease.
authors.affiliation: Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus , Denmark.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Montomoli
authors.affiliation: Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus , Denmark.
authors.forename: Rune
authors.initials: R
authors.lastname: Erichsen
authors.affiliation: Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus , Denmark.
authors.forename: Kirstine Kobberøe
authors.initials: KK
authors.lastname: Søgaard
authors.affiliation: Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus , Denmark.
authors.forename: Dóra
authors.initials: D
authors.lastname: Körmendiné Farkas
authors.affiliation: Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus , Denmark.
authors.forename: Anna-Marie
authors.initials: AM
authors.lastname: Bloch Münster
authors.affiliation: Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus , Denmark.
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sørensen
keywords: CANCER; EPIDEMIOLOGY; LIVER; LIVER CIRRHOSIS; VENOUS THROMBOSIS