Hägg Lovisa, Ehrs Felicia, Lind Marcus, Johansson Magdalena
Department of Public Health and Clinical Medicine, Skellefteå Research Unit, Umeå University, Umeå, Sweden.
Thromb J. 2024 Aug 21;22(1):77. doi: 10.1186/s12959-024-00646-z.
Venous thromboembolism (VTE) has a high mortality rate and can be the first manifestation of cancer. We investigated the incidence of cancer after first-ever VTE and the association between VTE and all-cause mortality.
A Swedish cohort study that included 105,997 participants without previous cancer who underwent a health examination from 1985-2014 was conducted. Manually validated first-ever VTE events, incident cancer according to the Swedish cancer registry, and mortality were registered. Participants were followed until September 5, 2014.
The mean age at inclusion was 46.2 years, and 50.3% of participants were female. We identified 1303 persons in the cohort with a VTE and no previous cancer. Among these, 179 (13.7%) were diagnosed with cancer after the VTE event, resulting in a cancer incidence of 26.4 (95% CI 22.8-30.6) cases per 1000 person-years. The incidence was highest during the first 6 months after the VTE. In the study population, VTE was associated with an increased risk of cancer (HR 1.95 [95% CI 1.67-2.29] in a multivariable model). VTE was also associated with an increased risk of death (HR 6.30 [95% CI 5.82-6.81]) in a multivariable model). There was an interaction between sex and VTE in relation to both risk of cancer and mortality, with a stronger association in women.
The incidence of cancer is high after first-ever VTE, especially close to the VTE event. VTE seems to be a stronger risk marker in women than in men for both cancer and death.
静脉血栓栓塞症（VTE）死亡率高，且可能是癌症的首发表现。我们调查了首次发生VTE后癌症的发病率以及VTE与全因死亡率之间的关联。
开展了一项瑞典队列研究，纳入105997名既往无癌症且在1985年至2014年期间接受健康检查的参与者。人工验证首次发生的VTE事件、根据瑞典癌症登记处记录的新发癌症以及死亡率。对参与者进行随访直至2014年9月5日。
纳入时的平均年龄为46.2岁，50.3%的参与者为女性。我们在队列中识别出1303名发生VTE且既往无癌症的人。其中，179人（13.7%）在VTE事件后被诊断出患有癌症，癌症发病率为每1千人年26.4例（95%置信区间22.8 - 30.6）。发病率在VTE后的前6个月最高。在研究人群中，VTE与癌症风险增加相关（多变量模型中风险比为1.95 [95%置信区间1.67 - 2.29]）。多变量模型中，VTE还与死亡风险增加相关（风险比为6.30 [95%置信区间5.82 - 6.81]）。在癌症风险和死亡率方面，性别与VTE之间存在相互作用，女性中的关联更强。
首次发生VTE后癌症发病率高，尤其是在接近VTE事件时。对于癌症和死亡而言，VTE似乎在女性中比在男性中是更强的风险标志物。
