The incidence of venous thromboembolism among patients with primary lung cancer

Research output: Contribution to journalArticle

181 Citations (Scopus)

Abstract

Background: The incidence of venous thromboembolism (VTE) by lung cancer histology and stage is unknown. Objectives: To determine the incidence of VTE and the risk factors associated with development of VTE in a large population-based study of patients with non-small cell and small cell lung cancer. Methods: The California Cancer Registry was merged with the Patient Discharge Data Set to determine the incidence of VTE among lung cancer cases diagnosed between 1993 and 1999. Results: Among 91933 patients with newly diagnosed lung cancer, the 1-year and 2-year cumulative VTE incidences were 3.0% and 3.4%, respectively, with a person-time rate of 7.2 events/100 patient-years during the first 6months. The 1-year incidence of VTE was significantly increased in comparison to the general population [standardized incidence ratio = 21.2, 95% confidence interval (CI) = 20.4-22.0]. In a multivariate model, significant predictors of developing VTE within 1 year of non-small cell lung cancer (NSCLC) diagnosis were: younger age, the number of chronic medical comorbidities [hazard ratio (HR) = 2.8 if 3 vs. 0, 95% CI = 2.5-3.1], advancing cancer stage (HR = 4.0 for metastatic vs. local disease, 95% CI = 3.4-4.6) and adenocarcinoma histology (HR = 1.9 vs. squamous cell, 95% CI = 1.7-2.1). In multivariate models, VTE was a significant predictor of death within 2 years for both NSCLC and small cell lung cancer (SCLC), HR = 2.3, 95% CI = 2.2-2.4, and HR = 1.5, 95% CI = 1.3-1.7, respectively. Conclusions: Approximately 3% of lung cancer patients developed VTE within 2 years. The diagnosis of VTE was associated with a higher risk of death within 2 years for NSCLC and SCLC.

Original languageEnglish (US)
Pages (from-to)601-608
Number of pages8
JournalJournal of Thrombosis and Haemostasis
Volume6
Issue number4
DOIs
StatePublished - Apr 2008

Fingerprint

Venous Thromboembolism
Lung Neoplasms
Incidence
Confidence Intervals
Small Cell Lung Carcinoma
Non-Small Cell Lung Carcinoma
Histology
Patient Discharge
Population
Registries
Comorbidity
Neoplasms
Adenocarcinoma
Epithelial Cells

Keywords

  • Anticoagulation
  • Epidemiology
  • Incidence
  • Lung cancer
  • Outcomes
  • Thromboembolism

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The incidence of venous thromboembolism among patients with primary lung cancer. / Chew, Helen K; Davies, A. M.; Wun, Theodore; Harvey, Danielle J; Zhou, H.; White, Richard H.

In: Journal of Thrombosis and Haemostasis, Vol. 6, No. 4, 04.2008, p. 601-608.

Research output: Contribution to journalArticle

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title = "The incidence of venous thromboembolism among patients with primary lung cancer",
abstract = "Background: The incidence of venous thromboembolism (VTE) by lung cancer histology and stage is unknown. Objectives: To determine the incidence of VTE and the risk factors associated with development of VTE in a large population-based study of patients with non-small cell and small cell lung cancer. Methods: The California Cancer Registry was merged with the Patient Discharge Data Set to determine the incidence of VTE among lung cancer cases diagnosed between 1993 and 1999. Results: Among 91933 patients with newly diagnosed lung cancer, the 1-year and 2-year cumulative VTE incidences were 3.0{\%} and 3.4{\%}, respectively, with a person-time rate of 7.2 events/100 patient-years during the first 6months. The 1-year incidence of VTE was significantly increased in comparison to the general population [standardized incidence ratio = 21.2, 95{\%} confidence interval (CI) = 20.4-22.0]. In a multivariate model, significant predictors of developing VTE within 1 year of non-small cell lung cancer (NSCLC) diagnosis were: younger age, the number of chronic medical comorbidities [hazard ratio (HR) = 2.8 if 3 vs. 0, 95{\%} CI = 2.5-3.1], advancing cancer stage (HR = 4.0 for metastatic vs. local disease, 95{\%} CI = 3.4-4.6) and adenocarcinoma histology (HR = 1.9 vs. squamous cell, 95{\%} CI = 1.7-2.1). In multivariate models, VTE was a significant predictor of death within 2 years for both NSCLC and small cell lung cancer (SCLC), HR = 2.3, 95{\%} CI = 2.2-2.4, and HR = 1.5, 95{\%} CI = 1.3-1.7, respectively. Conclusions: Approximately 3{\%} of lung cancer patients developed VTE within 2 years. The diagnosis of VTE was associated with a higher risk of death within 2 years for NSCLC and SCLC.",
keywords = "Anticoagulation, Epidemiology, Incidence, Lung cancer, Outcomes, Thromboembolism",
author = "Chew, {Helen K} and Davies, {A. M.} and Theodore Wun and Harvey, {Danielle J} and H. Zhou and White, {Richard H}",
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T1 - The incidence of venous thromboembolism among patients with primary lung cancer

AU - Chew, Helen K

AU - Davies, A. M.

AU - Wun, Theodore

AU - Harvey, Danielle J

AU - Zhou, H.

AU - White, Richard H

PY - 2008/4

Y1 - 2008/4

N2 - Background: The incidence of venous thromboembolism (VTE) by lung cancer histology and stage is unknown. Objectives: To determine the incidence of VTE and the risk factors associated with development of VTE in a large population-based study of patients with non-small cell and small cell lung cancer. Methods: The California Cancer Registry was merged with the Patient Discharge Data Set to determine the incidence of VTE among lung cancer cases diagnosed between 1993 and 1999. Results: Among 91933 patients with newly diagnosed lung cancer, the 1-year and 2-year cumulative VTE incidences were 3.0% and 3.4%, respectively, with a person-time rate of 7.2 events/100 patient-years during the first 6months. The 1-year incidence of VTE was significantly increased in comparison to the general population [standardized incidence ratio = 21.2, 95% confidence interval (CI) = 20.4-22.0]. In a multivariate model, significant predictors of developing VTE within 1 year of non-small cell lung cancer (NSCLC) diagnosis were: younger age, the number of chronic medical comorbidities [hazard ratio (HR) = 2.8 if 3 vs. 0, 95% CI = 2.5-3.1], advancing cancer stage (HR = 4.0 for metastatic vs. local disease, 95% CI = 3.4-4.6) and adenocarcinoma histology (HR = 1.9 vs. squamous cell, 95% CI = 1.7-2.1). In multivariate models, VTE was a significant predictor of death within 2 years for both NSCLC and small cell lung cancer (SCLC), HR = 2.3, 95% CI = 2.2-2.4, and HR = 1.5, 95% CI = 1.3-1.7, respectively. Conclusions: Approximately 3% of lung cancer patients developed VTE within 2 years. The diagnosis of VTE was associated with a higher risk of death within 2 years for NSCLC and SCLC.

AB - Background: The incidence of venous thromboembolism (VTE) by lung cancer histology and stage is unknown. Objectives: To determine the incidence of VTE and the risk factors associated with development of VTE in a large population-based study of patients with non-small cell and small cell lung cancer. Methods: The California Cancer Registry was merged with the Patient Discharge Data Set to determine the incidence of VTE among lung cancer cases diagnosed between 1993 and 1999. Results: Among 91933 patients with newly diagnosed lung cancer, the 1-year and 2-year cumulative VTE incidences were 3.0% and 3.4%, respectively, with a person-time rate of 7.2 events/100 patient-years during the first 6months. The 1-year incidence of VTE was significantly increased in comparison to the general population [standardized incidence ratio = 21.2, 95% confidence interval (CI) = 20.4-22.0]. In a multivariate model, significant predictors of developing VTE within 1 year of non-small cell lung cancer (NSCLC) diagnosis were: younger age, the number of chronic medical comorbidities [hazard ratio (HR) = 2.8 if 3 vs. 0, 95% CI = 2.5-3.1], advancing cancer stage (HR = 4.0 for metastatic vs. local disease, 95% CI = 3.4-4.6) and adenocarcinoma histology (HR = 1.9 vs. squamous cell, 95% CI = 1.7-2.1). In multivariate models, VTE was a significant predictor of death within 2 years for both NSCLC and small cell lung cancer (SCLC), HR = 2.3, 95% CI = 2.2-2.4, and HR = 1.5, 95% CI = 1.3-1.7, respectively. Conclusions: Approximately 3% of lung cancer patients developed VTE within 2 years. The diagnosis of VTE was associated with a higher risk of death within 2 years for NSCLC and SCLC.

KW - Anticoagulation

KW - Epidemiology

KW - Incidence

KW - Lung cancer

KW - Outcomes

KW - Thromboembolism

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