Advanced

Risk of thromboembolic diseases in men with prostate cancer: results from the population-based PCBaSe Sweden

Van Hemelrijck, Mieke; Adolfsson, Jan; Garmo, Hans; Bill-Axelson, Anna; Bratt, Ola LU ; Ingelsson, Erik; Lambe, Mats; Stattin, Par and Holmberg, Lars (2010) In The Lancet Oncology 11(5). p.450-458
Abstract
Background Cancer is associated with an increased risk of thromboembolic diseases, but data on the association between prostate cancer and thromboembolic diseases are scarce. We investigated the risk of thromboembolic disease in men with prostate cancer who were receiving endocrine treatment, curative treatment, or surveillance. Methods We analysed data from PCBaSe Sweden, a database based on the National Prostate Cancer Register, which covers over 96% of prostate cancer cases in Sweden. Standardised incidence ratios (SIR) of deep-venous thrombosis (DVT), pulmonary embolism, and arterial embolism were calculated by comparing observed and expected (using the total Swedish male population) occurrences of thromboembolic disease, taking into... (More)
Background Cancer is associated with an increased risk of thromboembolic diseases, but data on the association between prostate cancer and thromboembolic diseases are scarce. We investigated the risk of thromboembolic disease in men with prostate cancer who were receiving endocrine treatment, curative treatment, or surveillance. Methods We analysed data from PCBaSe Sweden, a database based on the National Prostate Cancer Register, which covers over 96% of prostate cancer cases in Sweden. Standardised incidence ratios (SIR) of deep-venous thrombosis (DVT), pulmonary embolism, and arterial embolism were calculated by comparing observed and expected (using the total Swedish male population) occurrences of thromboembolic disease, taking into account age, calendar-time, number of thromboembolic diseases, and time since previous thromboembolic disease. Findings Between Jan 1, 1997, and Dec 31, 2007, 30 642 men received primary endocrine therapy, 26 432 curative treatment, and 19 526 surveillance. 1881 developed a thromboembolic disease. For men on endocrine therapy, risks for DVT (SIR 2.48, 95% CI 2.25-2.73) and pulmonary embolism (1.95, 1.81-2.15) were increased, although this was not the case for arterial embolism (1.00, 0.82-1.20). Similar patterns were seen for men who received curative treatment (DVT: 1.73, 1.47-2.01; pulmonary embolism: 2.03, 1.79-2.30; arterial embolism: 0.95, 0.69-1.27) and men who were on surveillance (DVT: 1.27, 1.08-1.47; pulmonary embolism: 1.57, 1.38-1.78; arterial embolism: 1.08, 0.87-133). Increased risks for thromboembolic disease were maintained when patients were stratified by age and tumour stage. Interpretation All men with prostate cancer were at higher risk of thromboembolic diseases, with the highest risk for those on endocrine therapy. Our results indicate that prostate cancer itself, prostate cancer treatments, and selection mechanisms all contribute to increased risk of thromboembolic disease. Thromboembolic disease should be a concern when managing patients with prostate cancer. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The Lancet Oncology
volume
11
issue
5
pages
450 - 458
publisher
Elsevier
external identifiers
  • wos:000278478800020
  • scopus:77952305940
ISSN
1474-5488
DOI
10.1016/S1470-2045(10)70038-3
language
English
LU publication?
yes
id
924532a4-c705-40f9-8ccd-6a4a49c4915f (old id 1630922)
date added to LUP
2010-07-21 13:39:48
date last changed
2018-06-10 03:17:17
@article{924532a4-c705-40f9-8ccd-6a4a49c4915f,
  abstract     = {Background Cancer is associated with an increased risk of thromboembolic diseases, but data on the association between prostate cancer and thromboembolic diseases are scarce. We investigated the risk of thromboembolic disease in men with prostate cancer who were receiving endocrine treatment, curative treatment, or surveillance. Methods We analysed data from PCBaSe Sweden, a database based on the National Prostate Cancer Register, which covers over 96% of prostate cancer cases in Sweden. Standardised incidence ratios (SIR) of deep-venous thrombosis (DVT), pulmonary embolism, and arterial embolism were calculated by comparing observed and expected (using the total Swedish male population) occurrences of thromboembolic disease, taking into account age, calendar-time, number of thromboembolic diseases, and time since previous thromboembolic disease. Findings Between Jan 1, 1997, and Dec 31, 2007, 30 642 men received primary endocrine therapy, 26 432 curative treatment, and 19 526 surveillance. 1881 developed a thromboembolic disease. For men on endocrine therapy, risks for DVT (SIR 2.48, 95% CI 2.25-2.73) and pulmonary embolism (1.95, 1.81-2.15) were increased, although this was not the case for arterial embolism (1.00, 0.82-1.20). Similar patterns were seen for men who received curative treatment (DVT: 1.73, 1.47-2.01; pulmonary embolism: 2.03, 1.79-2.30; arterial embolism: 0.95, 0.69-1.27) and men who were on surveillance (DVT: 1.27, 1.08-1.47; pulmonary embolism: 1.57, 1.38-1.78; arterial embolism: 1.08, 0.87-133). Increased risks for thromboembolic disease were maintained when patients were stratified by age and tumour stage. Interpretation All men with prostate cancer were at higher risk of thromboembolic diseases, with the highest risk for those on endocrine therapy. Our results indicate that prostate cancer itself, prostate cancer treatments, and selection mechanisms all contribute to increased risk of thromboembolic disease. Thromboembolic disease should be a concern when managing patients with prostate cancer.},
  author       = {Van Hemelrijck, Mieke and Adolfsson, Jan and Garmo, Hans and Bill-Axelson, Anna and Bratt, Ola and Ingelsson, Erik and Lambe, Mats and Stattin, Par and Holmberg, Lars},
  issn         = {1474-5488},
  language     = {eng},
  number       = {5},
  pages        = {450--458},
  publisher    = {Elsevier},
  series       = {The Lancet Oncology},
  title        = {Risk of thromboembolic diseases in men with prostate cancer: results from the population-based PCBaSe Sweden},
  url          = {http://dx.doi.org/10.1016/S1470-2045(10)70038-3},
  volume       = {11},
  year         = {2010},
}