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Patients with cancer have highly increased risk for blood clots

ation who also had cancer had a 12-fold increased risk vs. individuals without cancer and factor V Leiden. Similar results were indirectly calculated for the prothrombin 20210A mutation in patients with cancer.

"Assuming a baseline risk of 1 to 4 patients with venous thrombosis per 1,000 per year, a 5 percent prevalence of factor V Leiden and a 2 percent prevalence of the prothrombin 20210A mutation, among 10,000 patients with cancer, we would expect 8 to 34 patients with venous thrombosis due to factor V Leiden or the prothrombin 20210A mutation. Screening for factor V Leiden and the prothrombin 20210A mutation and subsequent prophylactic anticoagulant therapy with an effectivity of 80 percent would prevent annually 7 to 27 venous thrombotic events per 10,000 patients with cancer screened (numbers needed to screen: 700-2,700), which does not make screening a useful strategy. Rather than screening for factor V Leiden or the prothrombin 20210A mutation, it may be more cost-effective to consider prophylactic anticoagulant therapy for patients with cancer who have an increased risk to develop venous thrombosis," the authors conclude.
(JAMA. 2005;293:715-722. Available post-embargo at JAMA.com)

Editor's Note: This research was supported by grants from the Netherlands Heart Foundation and from the Dutch Cancer Foundation.


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Contact: Frits R. Rosendaal, M.D., Ph.D.
f.r.rosendaal@lumc.nl
JAMA and Archives Journals
8-Feb-2005


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