Late Venous Thromboembolism in Survivors of Adolescent and Young Adult Cancer: A Population-Based Study in California

Details

• Alternative Title:
  Thromb Res
• Personal Author:
  Abrahão, Renata ; Brunson, Ann ; Chubak, Jessica ; Wernli, Karen J. ; Nichols, Hazel B. ; Chao, Chun ; Ruddy, Kathryn J. ; Hahn, Erin E. ; Li, Qian ; Malogolowkin, Marcio H. ; Sauder, Candice A.M. ; Kushi, Lawrence H. ; Wun, Ted ; Keegan, Theresa H.M.
• Description:
  Introduction
  
  Venous thromboembolism (VTE), a common complication in cancer patients, occurs more often during the initial phase of treatment. However, information on VTE beyond the first two years after diagnosis (‘late VTE’) is scarce, particularly in young survivors.
  
  Methods
  
  We examined the risk of, and factors associated with, late VTE among adolescents and young adults (AYA, 15–39 years) diagnosed with cancer (2006–2018) who survived ≥2 years. Data were obtained from the California Cancer Registry linked to hospitalization, emergency department and ambulatory surgery data. We used non-parametric models and Cox proportional hazard regression for analyses.
  
  Results
  
  Among 59,343 survivors, the 10-year cumulative incidence of VTE was 1.93% (CI 1.80–2.07). The hazard of VTE was higher among those who had active cancer, including progression from lower stages to metastatic disease (Hazard Ratio (HR)=10.41, 95% confidence interval (CI): 8.86–12.22), second primary cancer (HR=2.58, CI:2.01–3.31), or metastatic disease at diagnosis (HR=2.38, CI:1.84–3.09). The hazard of late VTE was increased among survivors who underwent hematopoietic cell transplantation, those who received radiotherapy, had a VTE history, public insurance (vs private) or non-Hispanic Black/African American race/ethnicity (vs non-Hispanic White). Patients with leukemias, lymphomas, sarcoma, melanoma, colorectal, breast, and cervical cancers had a higher VTE risk than those with thyroid cancer.
  
  Conclusions
  
  VTE risk remained elevated ≥2 years following cancer diagnosis in AYA survivors. Active cancer is a significant risk factor for VTE. Future studies might determine if late VTE should prompt evaluation for recurrence or second malignancy, if not already known.
  
  
• Subjects:
  Adolescent Humans Neoplasms Proportional Hazards Models Risk Factors Survivors Venous Thromboembolism Young Adult
• Keywords:
  Adolescents And Young Adults Cancer Metastatic Disease Recurrence Second Cancer Venous Thromboembolism VTE
• Source:
  Thromb Res. 235:1-7
• Pubmed ID:
  38244373
• Pubmed Central ID:
  PMC10989999
• Document Type:
  Journal Article
• Funding:
  HHSN261201800032C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009C/CA/NCI NIH HHSUnited States/ ; NU58DP006344/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800015I/CA/NCI NIH HHSUnited States/ ; P01 CA233432/CA/NCI NIH HHSUnited States/ ; HHSN261201800032I/CA/NCI NIH HHSUnited States/ ; HHSN261201800015C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009I/CA/NCI NIH HHSUnited States/
• Volume:
  235
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:52f7782f78842334de4979ece99095841cfcde2630f6b4e59a6644f23b3e28e2229c341d922abe0ed3803785b51a74789b8f3aaf215233266bbfb68fa5110828
• Download URL:
  https://stacks.cdc.gov/view/cdc/154074/cdc_154074_DS1.pdf
• File Type:
  [PDF - 477.51 KB ]