The intricate relationship between cancer and thrombosis has been a subject of ongoing research. While it’s well-established that these conditions are linked, large-scale, population-based studies quantifying the risk of both arterial thromboembolism (ATE) and venous thromboembolism (VTE) in cancer patients have been crucial to understanding the depth of this connection. This article delves into a significant study that utilized the International Classification of Disease 10th Revision (ICD-10) diagnosis codes to investigate this very interrelation, with a particular focus on Diagnosis Code 7244, a key indicator within this research.
This comprehensive study extracted data from the Austrian Association of Social Security Providers dataset, encompassing all publicly insured individuals in Austria from 2006-07. The researchers meticulously analyzed data from over 8 million individuals, categorizing patients based on ICD-10 codes. Cancer patients were identified by at least one ‘C’ diagnosis code, while those with ATE and/or VTE were flagged using codes such as I21/I24 (myocardial infarction), I63/I64 (stroke), I74 (arterial embolism), and crucially, I26/I80/I82, which includes diagnosis code 7244 and related codes for venous thromboembolism.
Within the cohort of 158,675 cancer patients, a significant 7,244 individuals, or 4.6%, were found to have a VTE diagnosis code, including diagnosis code 7244. This is a stark contrast to the non-cancer population, where only 0.4% presented with a VTE diagnosis. Similarly, ATE diagnoses were also significantly higher in cancer patients (5.4%) compared to those without cancer (0.9%). Statistical analysis revealed age-stratified random-effects relative risks (RR) of 6.88 for ATE and a striking 14.91 for VTE in cancer patients. These figures underscore a substantially elevated risk of both ATE and VTE in individuals diagnosed with cancer.
The study further explored the proportions of ATE and VTE across different cancer types. Urinary tract malignancies showed the highest ATE proportion (RR: 7.16), while endocrine cancers had the lowest (RR: 2.49). For VTE, cancers of the mesothelium and soft tissue exhibited the highest proportion (RR: 19.35), and oropharyngeal cancer the lowest (RR: 6.62). These variations suggest that the thrombotic risk is not uniform across all cancer types, highlighting the complexity of the cancer-thrombosis interaction.
In conclusion, this population-based study provides compelling evidence for a significantly increased relative risk of both ATE and VTE in individuals with cancer. The data, highlighted by the prevalence of diagnosis code 7244 within the VTE group, strongly supports the concept of shared risk factors and underlying pathobiology between cancer, arterial thromboembolism, and venous thromboembolism. Understanding this heightened risk is crucial for clinicians in managing cancer patients and considering prophylactic measures to mitigate thromboembolic events.
