ICE guidelines advocate further investigations for cancer with an abdomino-pelvic CT scan (CT A/P) in all patients aged over 40 years with a first unprovoked PE
Do you accept this recommendation ?
Prostate and breast cancers are most common.
Embolia is found in CT ... why not to continue with that ?
Absolutely. The link between thromboembolism and cancer has been recognized for over a century. Gastrointestinal (GI) cancers are associated with a high incidence of thromboembolic events. GI cancers (pancreas, stomach, liver, colon, rectum) are among the top 10 cancers with the highest rate of deep vein thrombosis and ulmonary embolism. In addition, the risk of cancer within 1 year after idiopathic DVT or Pulmonary Embolism is elevated for pancreatic cancer, gastric cancer, esophageal cancer, colorectal cancer, and primary liver cancer. Studies havE found a rate of VTE of 8.6% among GI cancer patients, compared with 3.3% in patients with non-GI cancers.
Thus it is highly recommended that persons with VTE/PE should not only undergo screening for GI malignancy through A/P CT but also be evaluated with follow up ultrasound/CT to look for subsequent development of cancer.
Heikki Vierola
Ishan Kumar
Many studies at the last ERS congress shows the percent of confirmed diagnosis of malignancy not pass 1%
- Badges
- Science topic