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. 2018 Apr;24(3):489-495.
doi: 10.1177/1076029617711805. Epub 2017 Jul 6.

Sex Differences in Patients With Occult Cancer After Venous Thromboembolism

Luis Jara-Palomares  1 , Remedios Otero  1 , David Jiménez  2 , Juan Manuel Praena-Fernández  3 , Agustina Rivas  4 , Carme Font  5 , Philip S Wells  6 , Raquel López-Reyes  7 , José González-Martínez  8 , Manuel Monreal  9
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Free PMC article

Sex Differences in Patients With Occult Cancer After Venous Thromboembolism

Luis Jara-Palomares et al. Clin Appl Thromb Hemost. 2018 Apr.
Free PMC article

Abstract

In patients with venous thromboembolism (VTE), male sex has been associated with an increased risk of occult cancer. The influence of sex on clinical characteristics, treatment, cancer sites, and outcome has not been thoroughly investigated yet. We used the Registro Informatizado Enfermedad TromboEmbólica registry to compare the clinical characteristics, treatment strategies, cancer sites, and clinical outcomes in patients with VTE having occult cancer, according to sex. As of June 2014, 5864 patients were recruited, of whom 444 (7.6%; 95% confidence interval: 6.8-8.2) had occult cancer. Of these, 246 (55%) were men. Median time elapsed from VTE to occult cancer was 4 months (interquartile range: 2-8.4), with no sex differences. Women were older, weighed less, and were less likely to have chronic lung disease than men. The most common cancer sites were the lung (n = 63), prostate (n = 42), and colorectal (n = 29) in men and colorectal (n = 38), breast (n = 23), uterine (n = 18), hematologic (n = 17), or pancreas (n = 15) in women. Men were more likely to have lung cancer than women (2.18% vs 0.30%; P < .01) and less likely to have pancreatic cancer (0.17% vs 0.5%; P = .03). Interestingly, breast cancer was more likely found in women aged ≥50 years than in those aged <50 years (0.97% vs 0.14%; P = .03). This study highlights the existence of sex differences in patients with VTE having occult cancer. One in every 2 men had lung, prostate, or colorectal cancer. In women, there is a heterogeneity of cancer sites, increasing risk of breast cancer in those aged >50 years.

Keywords: deep vein thrombosis; neoplasm; pulmonary embolism; sex; venous thromboembolism.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article:

Figures

Figure 1.
Figure 1.
Cumulative rates of occult cancer according to sex. Time-to-event data.
Figure 2.
Figure 2.
Decision tree. Score as predictor of occult cancer, according to sex. Patient is classified according to sex and as low or high risk according to score (≥3: high risk and ≤2: low risk).
Figure 3.
Figure 3.
Comparative cancer sites according to sex.
Figure 4.
Figure 4.
Comparative cancer sites in women by age (<50 vs ≥50 years).
See this image and copyright information in PMC

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References

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