African-Americans are at higher risk for cancer-associated venous thromboembolism (VTE) as compared with patients from other races.
VTE is a condition in which a blood clot forms in a vein and then dislodges to travel in the bloodstream. In the U.S., VTE is responsible for an estimated 300,000 deaths annually and an estimated 20 percent of these deaths occur among patients with cancer. Several studies have shown that patients with cancer are at a significantly increased risk of developing VTE, yet the influence of race on cancer-associated VTE remains unexplored until now.
Researchers from Boston University School of Medicine (BUSM) identified 16,498 subjects with organ and hematologic cancers from 2004 to 2018. Among this group they identified 186 VTE cases, of which the majority of the events occurred within the first two years of cancer diagnosis. Overall, African American patients showed a three times higher incidence of VTE compared with Caucasian patients. This difference was observed in certain cancer types such as lung, gastric (stomach) and colorectal. In lung cancer, the odds of developing VTE in African American patients was 2.77-times greater than those in white patients.
Studies have shown that VTE is the second most common cause of non-cancer related deaths in patients with cancer and is a significant predictor of decreased survival during the first year for all cancer types. However, current models for predicting a patient's risk of developing VTE do not factor in race and, as such, are likely incomplete and inaccurate.
The BUSM researchers believe that this study has implications for creating new tools that integrate race as a risk factor to help clinicians more accurately predict the risk for developing VTE in patients with cancer.
The integration of race into treatment algorithms for anticoagulation in cancer patients may further optimize risk-predictive models and more accurately stratify the risk of cancer-associated VTE."
Vipul Chitalia, MD, PhD, corresponding author, associate professor of medicine at BUSM
Addo-Tabiri, N., et al. (2019) Black Patients Experience Highest Rates of Cancer-associated Venous Thromboembolism. American Journal of Clinical Oncology. doi.org/10.1097/COC.0000000000000639.