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Background: People with cancer experience high rates of venous thromboembolism (VTE). Additionally, risk of subsequent cancer is increased in people experiencing their first VTE. The causal mechanisms underlying this association are not completely understood, and it is unknown whether VTE is itself a risk factor for cancer.
Methods: We used data from large genome-wide association study meta-analyses to perform bi-directional Mendelian randomisation analyses to estimate causal associations between genetically-proxied lifetime risk of VTE and risk of 18 different cancers.
Results: We found no conclusive evidence that genetically-proxied lifetime risk of VTE was causally associated with an increased incidence of cancer, or vice-versa. We observed an association between VTE and pancreatic cancer risk (odds ratio for pancreatic cancer 1.23 (95% confidence interval 1.08 - 1.40) per log-odds increase in risk of VTE, = 0.002). However, sensitivity analyses revealed this association was predominantly driven by a variant proxying non-O blood group, with inadequate evidence from Mendelian randomisation to suggest a causal relationship.
Conclusions: These findings do not support the hypothesis that genetically-proxied lifetime risk of VTE is a cause of cancer. Existing observational epidemiological associations between VTE and cancer are therefore more likely to be driven by pathophysiological changes which occur in the setting of active cancer and anti-cancer treatments. Further work is required to explore and synthesise evidence for these mechanisms.
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http://dx.doi.org/10.1101/2023.05.16.23289792 | DOI Listing |
Thromb Res
September 2025
Department of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan.
Background: The risk-benefit balance of extended anticoagulation in patients with metastatic cancer remains unclear.
Objectives: This prespecified subgroup analysis aimed to evaluate the efficacy and safety of 12-and 3-month edoxaban treatment in patients with cancer-associated isolated distal deep vein thrombosis (DVT) based on cancer metastasis.
Methods: The ONCO DVT study, a randomized clinical trial, included 601 patients with cancer-associated isolated distal DVT, divided into metastasis (N = 147) and no metastasis subgroups (N = 454).
IEEE J Biomed Health Inform
September 2025
This study aims to optimize the dynamic administration regimen of prophylactic enoxaparin in critically ill patients to reduce the risk of VTE, major bleeding, and 30-day all-cause mortality. We developed and internally and externally validated an artificial intelligence (AI) policy utilizing Double dueling deep Q network, using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database (training and internal test set) and the eICU Collaborative Research Database (eICU-CRD, external test set). We compared the performance among the AI policy, the clinician's policy, the weight-tiered policy, and the fixed 40- mg-once-daily (QD) policy.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla.
Importance: Janus kinase (JAK) inhibitors are highly effective medications for several immune-mediated inflammatory diseases (IMIDs). However, safety concerns have led to regulatory restrictions.
Objective: To compare the risk of adverse events with JAK inhibitors vs tumor necrosis factor (TNF) antagonists in patients with IMIDs in head-to-head comparative effectiveness studies.
J Ultrasound Med
September 2025
Evandro Chagas Infectious Diseases National Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Objectives: The risk of major venous thromboembolism (VTE) among patients with COVID-19 is high but varies with disease severity. Estimate the incidence of lower extremity deep venous thrombosis (DVT) in critically ill hospitalized patients with COVID-19, validate the Wells score for DVT diagnosis, and determine patients' prognosis.
Methods: This was an observational follow-up study in the context of the diagnosis and prognosis of DVT.
BMJ Open
September 2025
Department of Orthopaedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Introduction: The management of bleeding and coagulation after total knee arthroplasty (TKA) has long been recognised as a significant challenge for orthopaedic surgeons. Despite the notable success of empirical anticoagulation in preventing venous thromboembolism (VTE) following TKA, the increased risk of postoperative bleeding has also raised extensive concern. Ecchymosis, as one of the most common manifestations indicating postoperative bleeding, holds the potential to indicate the balance of bleeding and hypercoagulation.
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