Prevalence of occult cancer is low among patients with first unprovoked venous thromboebolism (VTE), according to a Canadian study published in The New England Journal of Medicine.

In a multicenter, open-label, controlled trial, researchers led by Marc Carrier, MD, of the Ottawa Hospital Research Institute randomized 854 patients with unprovoked VTE to either limited occult-cancer screening or limited occult-cancer screening in combination with comprehensive computed tomography (CT).

Primary outcome was confirmed cancer that was missed by the screening strategy but detected by the end of the one-year follow-up.

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The researchers found that 14 of the 431 patients in the limited-screening group as well as 19 of the 423 patients in the limited-screening with CT group had a new diagnosis of occult cancer between randomization and one-year follow-up.

They also found that, upon primary analysis, four occult cancers were missed by the limited-screening strategy as well as five occult cancers in the limited-screening plus CT strategy. No significant difference was found between the two groups with regard to mean time to cancer diagnosis.


  1. Carrier, Marc, MD, et al. “Screening for Occult Cancer in Unprovoked Venous Thromboembolism.” The New England Journal of Medicine. DOI: 10.1056/NEJMoa1506623. June 22, 2015.