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DOI: 10.1055/s-0042-1759879
Increased Cancer Risk in Patients with Kidney Disease and Venous Thromboembolism: A Population-Based Cohort Study
Funding This work was supported by Aarhus University. The sponsor had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Abstract
Background Venous thromboembolism (VTE) may be a harbinger of cancer in the general population. Patients with kidney disease have an a priori increased VTE risk. However, it remains unknown how a VTE affects subsequent cancer risk in these patients.
Objectives To examine the cancer risk in patients with kidney disease following a VTE.
Methods We conducted a nationwide population-based cohort study in Denmark (1996–2017), including all VTE patients with a diagnosis of kidney disease. We calculated absolute risks of cancer (accounting for competing risk of death) and age-, sex-, and calendar-period standardized incidence ratios (SIRs) comparing the observed cancer incidence with national cancer incidence rates and cancer incidence rates of VTE patients without kidney disease.
Results We followed 3,362 VTE patients with kidney disease (45.9% females) for a median follow-up time of 2.4 years (interquartile range: 0.6–5.4). During follow-up, 464 patients were diagnosed with cancer, of whom 169 (36.4%) were diagnosed within the first year. The 1-year absolute risk of any cancer was 5.0% (95% confidence interval [CI]: 4.3–5.8), with a SIR of 2.9 (95% CI: 2.5–3.4) when compared with the general population, and 2.0 (95% CI: 1.8–2.4) when compared with VTE patients without kidney disease. During subsequent years of follow-up, the SIRs declined to 1.5 (95% CI: 1.3–1.6) when compared with the general population, and 1.1 (95% CI: 0.9–1.2) compared with VTE patients without kidney disease.
Conclusion Patients with hospital-diagnosed kidney disease have increased cancer risk after VTE, especially within the first year following the VTE diagnosis.
Keywords
venous thromboembolism - deep vein thrombosis - pulmonary embolism - kidney disease - cancer - epidemiology - cohort studyAuthors' Contribution
All authors contributed to the methodology of the study. H.T.S. acquired the data. J.R.S., F.S.T., R.E., C.F.C., and H.T.S. directed the formal analyses, which were performed by D.N. and D.K.F. J.R.S. and F.S.T. wrote the initial draft. All authors contributed to the discussion and interpretation of the results, which secured the intellectual content of the manuscript. All authors reviewed, edited, and approved the final version of the manuscript for submission.
Data Availability Statement
All data generated or analyzed during this study are included in this published article (and in the Supplementary Material). All authors had full access to the data of this study.
Publication History
Received: 05 January 2022
Accepted: 18 October 2022
Article published online:
27 December 2022
© 2022. Thieme. All rights reserved.
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