Black patients at higher risk for cancer-associated venous thromboembolism
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Black patients with cancer appeared to be at a higher risk for cancer-associated venous thromboembolism than patients of other races, according to results of a retrospective study published in American Journal of Clinical Oncology.
These results justify the development of tools that include race as a risk factor to help clinicians assess VTE risk among patients with cancer, researchers noted.
“The integration of race into treatment algorithms for anticoagulation in [patients with cancer] may further optimize risk-predictive models and more accurately stratify the risk [for] cancer-associated VTE,” Vipul Chitalia, MD, PhD, associate professor of medicine at Boston University School of Medicine, said in a press release.
Patients with cancer are at a higher risk for VTE than the general population, and blacks in general population have a higher risk for VTE than whites. However, previous studies had not examined the impact of race on risk for cancer-associated VTE.
To do so, Chitalia and colleagues retrospectively analyzed 16,498 patients (33.3% black, 54.9% white, 11.75% other; 50.3% men) with solid or hematologic malignancies diagnosed at Boston Medical Center between 2004 and 2018.
Among all patients, researchers identified 186 unique VTE events, most of which occurred within 2 years of diagnosis.
Results showed that blacks had a three times higher incidence of VTE than whites (1.8% vs. 0.6%; P < .001). Researchers noted no statistically significant difference in average age, sex, BMI or presenting cancer stage among the racial groups. They observed the racial differences in VTE incidence in specific cancer types, including lung, gastric and colorectal cancers.
Black patients with lung cancer appeared 2.77 (95% CI, 1.33-5.91) times more likely to develop VTE than their white counterparts, after adjustment for age, sex, cancer stage and antithrombotic medication use.
Patients of other races also had a 2.77 (95% CI, 0.51-7.33) times higher risk for cancer-associated VTE than whites, but the difference did not reach statistical significance.
Although black patients had a higher incidence of VTE, they did not have a higher Khorana risk score — commonly used to predict risk for cancer-associated VTE before the start of chemotherapy — than white patients or patients of other races in the study population, which defied researchers’ expectations.
A reliance on discharge codes to calculate VTE events and self-identification of race served as the study's primary limitations.
“This study suggests that race may play a significant role in the development of cancer-associated VTE,” Chitalia and colleagues wrote. “The integration of race into treatment algorithms for anticoagulation in [patients with cancer] may further optimize risk-predictive models and more accurately stratify the risk [for] cancer-associated VTE. Finally, our study also lays the ground for mechanistic cause-and-effect inquiries related to intricate associations of specific cancers with VTE in blacks.” – by John DeRosier
Disclosures: Boston University Medical School, Evans Center Affinity Research Collaborative on Thrombosis and Hemostasis and NIH funded this study. Healio could not confirm the authors’ relevant financial disclosures at the time of reporting.
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