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Thromb Haemost
DOI: 10.1055/a-2679-6152
Stroke, Systemic or Venous Thromboembolism

Risk of Cancer in the Short and Long Term after Incident Venous Thromboembolism: The HUNT and Tromsø Studies

Camilla Langholm
1   Thrombosis Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
,
Nikolai Hagensen Eide
1   Thrombosis Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
,
Kristian Hveem
2   HUNT Center for Molecular and Clinical Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
3   Department of Public Health and Nursing, HUNT Research Center, Norwegian University of Science and Technology, Levanger, Norway
4   Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
,
Nick van Es
5   Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
6   Amsterdam Cardiovascular Sciences, Pulmonary Hypertension and Thrombosis, Amsterdam, The Netherlands
,
Sigrid K. Brækkan
1   Thrombosis Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
7   Department of Internal Medicine, Thrombosis Research Center, University Hospital of North Norway, Tromsø, Norway
,
Vânia M. Morelli
1   Thrombosis Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
7   Department of Internal Medicine, Thrombosis Research Center, University Hospital of North Norway, Tromsø, Norway
,
John-Bjarne Hansen
1   Thrombosis Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
7   Department of Internal Medicine, Thrombosis Research Center, University Hospital of North Norway, Tromsø, Norway
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Abstract

Background

Venous thromboembolism (VTE) has long been recognized as a harbinger of cancer. The epidemiology of VTE and cancer has evolved over the past decades, and contemporary data addressing the association between VTE and subsequent risk of cancer are needed.

Objectives

We aimed to investigate the short- (≤1 year) and long-term (>1 year) risk of cancer after incident VTE in a population-based cohort study.

Methods

A total of 111,119 participants from Tromsø4–7 (1994–2016) and HUNT2–3 (1995–2008) surveys were followed through 2020, and all first-lifetime cancer and VTE events were recorded. Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for cancer diagnosis in participants with VTE compared with those without VTE, with VTE being modeled as a time-varying exposure.

Results

Among the 2,506 individuals with incident VTE, 417 had a subsequent diagnosis of incident cancer during a median follow-up after VTE of 5.2 years. In models adjusted for age (as a time-scale), sex, body mass index, smoking, and comorbidities, the HRs for cancer were 4.57 (95% CI 3.89–5.37) at 0 to 1 year, 1.19 (95% CI 0.93–1.52) at 1 to 3 years, and 1.14 (95% CI 0.99–1.31) at >3 years after overall VTE when compared with individuals without VTE, and the risk estimates were particularly pronounced at 0 to 1 year after unprovoked VTE (HR 5.63, 95% CI 4.67–6.77).

Conclusion

Our results indicate a transient and substantially increased risk of cancer diagnosis within 1 year after an incident VTE, and especially after unprovoked VTE.

Keywords

cancer - venous thromboembolism - venous thrombosis - cohort - risk factor

Authors' Contribution

J.B.H. contributed to conception and design; K.H., S.K.B., and J.B.H. contributed to data collection; C.L. and S.K.B. contributed to statistical analysis; C.L., N.H.E., K.H., N.v.E., S.K.B., V.M.M., and J.B.H. contributed to interpretation of data; C.L., V.M.M., and J.B.H. contributed to draft of manuscript; C.L., N.H.E., K.H., N.v.E., S.K.B., V.M.M., and J.B.H. contributed to critical revision of manuscript. All co-authors reviewed and approved the final version.


Supplementary Material



Publication History

Received: 22 March 2025

Accepted: 07 August 2025

Accepted Manuscript online:
11 August 2025

Article published online:
25 August 2025

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