Page 17 - JCTR-11-4

Journal of Clinical and
Translational Research Hidden cancer after VTE

A

B

Figure 3. Forest plot comparing extensive versus limited screening for overall mortality (A) and cancer-related mortality (B)

Table 3. Quality assessment of included randomized controlled trials using the Jadad scale

Study Described as Described as Description of Randomization Double‑blinding Total Risk of
randomized* double‑blind* withdrawals* method method described score bias
described and and appropriate**
appropriate**
Piccioli et al. 16 1 1 0 1 1 4 Low
Carrier et al. 17 1 1 0 1 1 4 Low
Prandoni et al. 18 1 1 0 1 1 4 Low
Robin et al. 19 1 1 0 1 0 3 Low
Notes: *A study receives a score of 1 for “yes” and 0 for “no”; **A study receives a score of 0 if no description is given, 1 if the method is described and
appropriate, and -1 if the method is described but inappropriate.

history and physical examination, blood tests, a chest thoracic-abdominopelvic CT scan. At initial screening, one
X-ray, sex-specific cancer screenings (including pelvic patient was identified with chronic lymphocytic leukemia.
examination and Papanicolaou smear for women, and PSA During follow-up, three additional cancers were detected
testing or digital rectal examinations for men over 40 years (rectosigmoid adenocarcinoma with hepatic metastases,
old), and a CT scan of the abdomen and pelvis. The CT hepatocellular carcinoma, and gastric adenocarcinoma,
scan included a virtual colonoscopy and gastroscopy. It respectively). The mortality rate was 28%, with two deaths
identified abnormalities in eight patients (OR: 16%; 95% attributed to cancer.
CI: 7.0 – 28.5), leading to further investigations. These Limited and extensive cancer screening strategies
investigations resulted in the diagnosis of pancreatic were compared in another prospective cohort study. All
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adenocarcinomas in two patients (OR: 4.0%; 95% CI: 0.5 630 patients underwent baseline screening, which consisted
– 13.5), one of which was detected early (T1-2N0M0). of a history, physical examination, basic laboratory tests,
Additionally, three patients were diagnosed with and chest X-ray. The extensive screening group added
precancerous lesions. abdominal and chest CT scans and mammography. In
Rieu et al. investigated the efficacy of a screening 12 of the 342 (3.5%) patients in the extensive screening
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program for occult cancer in patients over 70 years group, cancer was diagnosed at baseline, compared with
old. The cohort comprised 50 patients undergoing a seven of 288 patients (2.4%) in the limited screening
12-month prospective follow-up. The screening included group. Extensive screening detected six additional
a medical history, clinical laboratory tests including cancers (OR: 2.0%; 95% CI: 0.7 – 4.3), of which three
tumor markers, abdominal ultrasound, chest X-ray, and were potentially curable. During a median of 2.5 years of

Volume 11 Issue 4 (2025) 11 doi: 10.36922/jctr.24.00069