title: Screening for Malignancy in Patients With Unprovoked Venous Thromboembolism: A Single-Center Retrospective Case Series.
abstract: In this prospective review of cancer screening in unselected patients with unprovoked venous thromboembolism (VTE) presenting to a large teaching hospital in the Republic of Ireland, we aimed to determine the effects of the implementation of the National Institute for Health and Care Excellence screening policy in a "real-world" population. Within our institution, 64 individuals presented with unprovoked VTE during the study period, of whom 47 underwent a screening computed tomography (CT) scan. Two cases of previously undiagnosed cancer were identified. However, in both cases, the clinical history provided by the affected individuals would have prompted a CT scan regardless of the recommendations of the screening policy. The screening CT scans identified 18 incidental lesions within the cohort, which required further diagnostic studies. None of the additional investigations completed to date have detected any lesion of clinical significance. These findings support the view that cancer screening with CT imaging in unselected individuals with unprovoked VTE is not justified or cost-effective.
authors.affiliation: 1 Department of Haematology, Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Aisling
authors.initials: A
authors.lastname: Barrett
authors.affiliation: 2 Department of Haematology, Rotunda Hospital, Dublin, Ireland.
authors.forename: Barry
authors.initials: B
authors.lastname: Kevane
authors.affiliation: 3 School of Medicine, University College Dublin (UCD), Dublin, Ireland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Hall
authors.affiliation: 1 Department of Haematology, Mater Misericordiae University Hospital, Dublin, Ireland.|2 Department of Haematology, Rotunda Hospital, Dublin, Ireland.|4 UCD Conway Institute SPHERE Research Group, UCD, Dublin, Ireland.|5 Irish Heart Foundation, Dublin, Ireland.
authors.forename: Fionnuala
authors.initials: F
authors.lastname: Ní Áinle
authors.affiliation: 6 Department of Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Tomás
authors.initials: T
authors.lastname: Breslin
mesh_terms: D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000191:economics*; D054556:Venous Thromboembolism / Q000150:complications*
keywords: deep venous thrombosis; pulmonary embolism; venous thromboembolism