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Avoid Unnecessary Cancer Screening Following Venous Thromboembolism, Says NEJM Study


A study published in the New England Journal of Medicine says a CT scan following a first venous thromboebolism event may not benefit in detecting cancer.

An NEJM study found that the prevalence of occult cancer was low among patients who had a first unprovoked venous thromboembolism, and routine screening with CT of the abdomen and pelvis was not clinically beneficial.

The study was conducted because unprovoked venous thromboembolism is thought of as an earliest sign of cancer, and up to 10% of patients with unprovoked venous thromboembolism receive a diagnosis of cancer within a year of the event and then gradually decreases. While the hypothesis is that early screening and intervention can reduce cancer-associated mortality, there's not enough data to support the practice. This has resulted in a wide variation in policy and clinical practice, write the authors. How intense should the intervention be and what should be included as a part of the screening strategy? These are some of the questions that remain unanswered.

In this study, the authors conducted a randomized clinical trial to assess the efficacy and safety of adding CT of the abdomen and pelvis to a limited screening strategy for occult cancer.

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Ruben A. Mesa, MD, president and executive director of Atrium Health Levine Cancer Institute and Atrium Health Wake Forest Baptist Comprehensive Cancer Center
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