Lee Lai Heng, Nagarajan Chandramouli, Tan Chuen Wen, Ng Heng Joo
Singapore General Hospital, Singapore, Singapore.
Front Cardiovasc Med. 2021 May 21;8:669288. doi: 10.3389/fcvm.2021.669288. eCollection 2021.
The epidemiology of cancer associated thrombosis (CAT) in Asia is less well-studied and differs from that in the western countries. Here, we systematically examine population based and hospital-based studies reported between 1995 and 2020 to understand the epidemiology of CAT in Asia. From population-based studies, the estimated incidence of VTE in cancer patients was 1.85-9.88 per 1,000 person-years. The incidence of CAT in Asia is significantly higher than non-cancer associated VTE in the general population and cancer is perhaps the most important risk factor for VTE. Hospital-based studies were heterogeneous in study designs and reveal a wide range of prevalence of VTE among cancer patients at 0.5-44.6% while the cancer prevalence rates among VTE patients ranged from 6.1 to 65.5%. The cancer sites most associated with VTE and risk factors were similar between Asian and Western studies. CAT has a major impact on the survival of patients with cancer in Asia, but thromboprophylaxis is not commonly practiced and validated risk assessment tools are lacking. This study highlights the urgent need for large multinational epidemiological studies in Asia to establish the true burden of CAT and to guide appropriate prevention strategies.
亚洲癌症相关血栓形成（CAT）的流行病学研究较少，且与西方国家不同。在此，我们系统地研究了1995年至2020年间基于人群和基于医院的研究，以了解亚洲CAT的流行病学情况。基于人群的研究表明，癌症患者静脉血栓栓塞（VTE）的估计发病率为每1000人年1.85 - 9.88例。亚洲CAT的发病率显著高于普通人群中非癌症相关的VTE，癌症可能是VTE最重要的危险因素。基于医院的研究在研究设计上存在异质性，显示癌症患者中VTE的患病率范围很广，为0.5% - 44.6%，而VTE患者中癌症的患病率范围为6.1%至65.5%。亚洲和西方研究中，与VTE最相关的癌症部位和危险因素相似。CAT对亚洲癌症患者的生存有重大影响，但血栓预防措施并不常用，且缺乏经过验证的风险评估工具。这项研究凸显了在亚洲开展大型跨国流行病学研究的迫切需求，以确定CAT的真实负担并指导适当的预防策略。
