OC 25.1 - Venous and Arterial Thromboembolism after Incident Colorectal Cancer in the Netherlands: Incidence, Predictors, and Prognosis

Sunday, July 10, 2022

2:45 PM – 3:00 PM

Location: ExCel Center, ICC Capital Suite Room 8&9

Presentation Format: In-Person

Presenting Author(s)

Rayna Anijs, MSc

PhD candidate
Leiden University Medical Center
Amsterdam, Noord-Holland, Netherlands

Co-Author(s)

Qingui Chen, MD

Phd student
Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands
WL

Willem Lijfering

Associate Professor
Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands
SC

Suzanne C. Cannegieter, MD PhD

Professor
Department of Clinical Epidemiology, Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands

Background: Cancer patients have an increased risk of venous and arterial thromboembolism (VTE/ATE). Colorectal cancer (CRC) is the third most prevalent cancer type, but the size of the risks and predictors of TE after CRC and subsequent mortality are not well known in detail at nationwide level.

Aims: To determine incidence, predictors and prognosis of TE occurring within 1 year after incident CRC.

Methods: Using data from Statistics Netherlands (CBS) and the Netherlands Comprehensive Cancer Organization (IKNL), incident CRC patients were identified between January 2013 and December 2018. CRC patients were matched on a 1:2 ratio to cancer-free controls on age, sex and cancer diagnosis date. Incidence rates and cumulative incidences were estimated for developing TE starting from date of diagnosis in 1 year follow-up. Predictor variables for TE in were explored by univariable Cox regression analyses. All-cause mortality in CRC was evaluated by multivariable Cox regression analyses, using TE as time-dependent exposure.

Results: 68238 incident CRC patients were matched to 136476 control subjects. The 1 year cumulative incidence of VTE was 1.93% (95%CI 1.83-2.04) in cancer patients versus 0.24% (0.21-0.27) in control subjects (HR 8.85; 7.83-9.99). For ATE, this was 2.74% (2.62-2.87) in cancer patients versus 1.88% (1.81-1.95) in control subjects (HR 1.57; 1.47-1.66). Significant predictors for VTE were cancer stage, surgery, chemotherapy, asthma, prior VTE and smoking, and for ATE; age, prior ATE, Parkinson’s disease, peripheral artery disease, depression and physical health. TE in CRC patients led to an increased risk of all-cause mortality (VTE HR; 3.68 (95%CI 3.30-4.10) and ATE HR; 3.05 (95%CI 2.75-3.39)), after adjusting for age, sex, comorbidities and tumor characteristics.

Conclusion(s): This Dutch nationwide study provides detailed information on size of VTE and ATE risks, their predictors and prognosis in patients with a CRC diagnosis. This information is important for targeted prevention of both types of TE in CRC.