Gade Inger Lise, Brækkan Sigrid K, Næss Inger Anne, Hansen John-Bjarne, Cannegieter Suzanne C, Rosendaal Frits R, Overvad Kim, Hindberg Kristian, Hammerstrøm Jens, Gran Olga V, Tjønneland Anne, Severinsen Marianne T, Kristensen Søren R
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Department of Clinical Medicine, K.G Jebsen Thrombosis Research and Expertise Centre (TREC), University of Tromsø-The Arctic University of Norway, Tromsø, Norway.
TH Open. 2018 Apr 6;2(2):e131-e138. doi: 10.1055/s-0038-1641678. eCollection 2018 Apr.
The risk of venous thromboembolism (VTE) in patients who survive the first years after a cancer diagnosis after the acute effects of disease and treatment in comparison to a similar background population has been sparsely investigated. The aim of the study was to investigate if incidence rates (IRs) of VTE differed in patients who were alive at least 2 years after a cancer diagnosis without VTE compared with cancer-free references in a population-based cohort study. The study entry was 2 years after a first cancer diagnosis. For each cancer-exposed subject, five reference subjects were identified within the cohort. The IRs were calculated as number of VTEs per 1,000 person years (×10 p-y) in total and in distinct cancer types and corresponding reference subjects. Incidence rate ratios (IRRs) were calculated by Poisson's regression. During a mean follow-up of 5.3 years, 110 VTEs occurred among the 7,288 cancer-exposed subjects and 321 VTEs occurred among the 36,297 identified reference subjects. The IR of VTE was higher for cancer-exposed subjects compared with reference subjects, IRs 3.7 × 10 p-y, 95% CI: 3.1 to 4.5 and 1.9 × 10 p-y, 95% CI: 1.7 to 2.2, respectively. IRs of VTE in most solid cancer types declined to almost the same level as in the reference subjects 2 years after cancer diagnosis, but remained higher in hematological cancers, IRR 4.0, 95% CI: 2.0 to 7.8.
与背景相似的人群相比，癌症诊断及疾病和治疗的急性影响后的头几年存活患者发生静脉血栓栓塞（VTE）的风险鲜有研究。本研究的目的是在一项基于人群的队列研究中，调查癌症诊断后至少存活2年且无VTE的患者与无癌对照者的VTE发病率（IR）是否存在差异。研究纳入时间为首次癌症诊断后2年。对于每一位癌症暴露受试者，在队列中确定五名对照受试者。IR按每1000人年（×10人年）的VTE数量计算，分别针对所有癌症类型、特定癌症类型及相应的对照受试者。发病率比（IRR）通过泊松回归计算。在平均5.3年的随访期间，7288名癌症暴露受试者中发生了110例VTE，36297名确定的对照受试者中发生了321例VTE。癌症暴露受试者的VTE IR高于对照受试者，分别为3.7×10人年，95%CI：3.1至4.5和1.9×10人年，95%CI：1.7至2.2。大多数实体癌类型的VTE IR在癌症诊断后2年降至与对照受试者几乎相同的水平，但血液系统癌症仍较高，IRR为4.0，95%CI：2.0至7.8。
