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No Clinical Benefit Found for Occult Cancer CT Screening in VTE

Prevalence of occult cancer low among patients with first unprovoked venous thromboembolism

MONDAY, June 22, 2015 (HealthDay News) -- Comprehensive computed tomography (CT) screening in addition to a limited occult-cancer screening offers no benefit over limited screening alone for patients with a first unprovoked venous thromboembolism. The finding was published online June 22 in the New England Journal of Medicine to coincide with the International Society on Thrombosis and Haemostasis 2015 Congress, held from June 20 to 25 in Toronto.

Marc Carrier, M.D., from the Ottawa Hospital Research Institute in Canada, and colleagues examined the efficacy of a screening strategy for occult cancer that included comprehensive CT of the abdomen and pelvis in patients with a first unprovoked venous thromboembolism. Eight hundred fifty-four patients were randomized to undergo limited occult-cancer screening (basic blood testing; chest radiography; and screening for breast, cervical, and prostate cancer) or limited occult cancer screening in combination with CT.

The researchers found that 3.9 percent of participants had a new diagnosis of occult cancer between randomization and one-year follow-up: 3.2 percent in the limited-screening group and 4.5 percent in the limited-screening-plus-CT group (P = 0.28). Twenty-nine and 26 percent of cancers were missed by the limited-screening and limited-screening-plus-CT strategies, respectively (P = 1.0). There was no significant between-group difference in the mean time to a cancer diagnosis (4.2 versus 4.0 months; P = 0.88) or in cancer-related mortality (1.4 versus 0.9 percent; P = 0.75).

"Routine screening with CT of the abdomen and pelvis did not provide a clinically significant benefit," the authors write.

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