Men with prostate cancer are at higher risk of thromboembolic diseases

January 01, 0001

Men with prostate cancer are at higher risk of thromboembolic diseases

Cancer is associated with an increased risk of thromboembolic diseases, but data on the association between prostate cancer and thromboembolic diseases are scarce. The researchers from the UK and Sweden investigated the risk of thromboembolic disease in men with prostate cancer who were receiving endocrine treatment, curative treatment, or surveillance. They analysed data from PCBaSe Sweden, a database based on the National Prostate Cancer Register, which covers over 96% of prostate cancer cases in Sweden. Standardised incidence ratios (SIR) of deep-venous thrombosis (DVT), pulmonary embolism, and arterial embolism were calculated by comparing observed and expected (using the total Swedish male population) occurrences of thromboembolic disease, taking into account age, calendar-time, number of thromboembolic diseases, and time since previous thromboembolic disease. Between Jan 1, 1997, and Dec 31, 2007, 30,642 men received primary endocrine therapy, 26,432 curative treatment, and 19,526 surveillance. 1881 developed a thromboembolic disease.

For men on endocrine therapy, risks for DVT (SIR 2.48) and pulmonary embolism (1.95) were increased, although this was not the case for arterial embolism (1.00). Similar patterns were seen for men who received curative treatment (DVT: 1.73; pulmonary embolism: 2.03; arterial embolism: 0.95) and men who were on surveillance (DVT: 1.27; pulmonary embolism: 1.57; arterial embolism: 1.08). Increased risks for thromboembolic disease were maintained when patients were stratified by age and tumour stage.

The researchers concluded: "All men with prostate cancer were at higher risk of thromboembolic diseases, with the highest risk for those on endocrine therapy. Our results indicate that prostate cancer itself, prostate cancer treatments, and selection mechanisms all contribute to increased risk of thromboembolic disease. Thromboembolic disease should be a concern when managing patients with prostate cancer."

Important for diagnosis and prevention.

For the full abstract, click here.

The Lancet Oncology 11(5):450-458, May 2010
© 2010 Elsevier Ltd
Risk of thromboembolic diseases in men with prostate cancer: results from the population-based PCBaSe Sweden. Mieke Van Hemelrijck, Jan Adolfsson, Hans Garmo et al. Correspondence to Mieke Van Hemelrijck:

Category: K. Circulatory. Keywords: risk, thromboembolic disease, men, prostate cancer, cohort study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 13 August 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.