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Thromb Haemost 2023; 123(12): 1165-1176
DOI: 10.1055/s-0042-1759879
Stroke, Systemic or Venous Thromboembolism

Increased Cancer Risk in Patients with Kidney Disease and Venous Thromboembolism: A Population-Based Cohort Study

Jakob Rønnow Sand 
1   Department of Clinical Epidemiology, Aarhus University Hospital and Clinical Institute of Arhus University, Aarhus N, Denmark
,
Frederikke Schønfeldt Troelsen
1   Department of Clinical Epidemiology, Aarhus University Hospital and Clinical Institute of Arhus University, Aarhus N, Denmark
,
Dávid Nagy
1   Department of Clinical Epidemiology, Aarhus University Hospital and Clinical Institute of Arhus University, Aarhus N, Denmark
,
Dóra Körmendiné Farkas
1   Department of Clinical Epidemiology, Aarhus University Hospital and Clinical Institute of Arhus University, Aarhus N, Denmark
,
Rune Erichsen
1   Department of Clinical Epidemiology, Aarhus University Hospital and Clinical Institute of Arhus University, Aarhus N, Denmark
2   Department of Surgery, Randers Regional Hospital, Randers NØ, Denmark
,
Christian Fynbo Christiansen
1   Department of Clinical Epidemiology, Aarhus University Hospital and Clinical Institute of Arhus University, Aarhus N, Denmark
,
Henrik Toft Sørensen
1   Department of Clinical Epidemiology, Aarhus University Hospital and Clinical Institute of Arhus University, Aarhus N, Denmark
› Institutsangaben
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.
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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 study

Authors' 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.


Supplementary Material



Publikationsverlauf

Eingereicht: 05. Januar 2022

Angenommen: 18. Oktober 2022

Artikel online veröffentlicht:
27. Dezember 2022

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Kommentar zu diesem Artikel:

Kidney Disease and Cancer Risk in Patients with Venous Thromboembolism: What Does It Mean for Clinical Practice?Thromb Haemost 2023; 123(12): 1177-1179
DOI: 10.1055/a-2152-4762