Page 9 - JCTR-11-4

Journal of Clinical and

Translational Research

REVIEW ARTICLE
Occult cancer screening in patients with venous

thromboembolism: A systematic review and
meta-analysis

1,2
3
4
Anabel Franco-Moreno * , José Manuel Ruiz-Giardin , Ana Martínez-Casa-Muñoz ,
and Cristina Lucía de Ancos-Aracil 3,5
1 Department of Internal Medicine, Hospital Universitario Infanta Leonor, Madrid, Spain
2 Venous Thromboembolism Unit, Hospital Universitario Infanta Leonor, Madrid, Spain
3 Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
4 Department of Geriatric, Hospital Universitario Gregorio Marañón, Madrid, Spain
5 Venous Thromboembolism Unit, Hospital Universitario de Fuenlabrada, Madrid, Spain

Abstract

*Corresponding author: Background: Unprovoked venous thromboembolism (VTE) can be the first clinical
Anabel Franco-Moreno manifestation of an undiagnosed cancer. A cancer diagnosis at an earlier stage
(anaisabel.franco@salud.madrid.org)
could reduce the risk of cancer progression and contribute to improvements in
Citation: Franco-Moreno A, Ruiz- cancer‐related mortality. Aim: This review analyzes whether extensive screening for
Giardin JM, Martínez-Casa-Muñoz
A, de Ancos-Aracil CL. Occult undiagnosed cancer in patients with a first episode of unprovoked VTE is effective in
cancer screening in patients reducing cancer-related mortality. Methods: Prospective studies in which patients
with venous thromboembolism: with an unprovoked VTE were allocated to receive specific tests for identifying cancer
A systematic review and meta-
analysis. J Clin Transl Res. were eligible for inclusion. To identify studies, PubMed, Web of Science, Cochrane
2025;11(4):3-17. Library, Scopus, EMBASE, Clinical Trials, the International Clinical Trials Registry
doi: 10.36922/jctr.24.00069 Platform, and the Cochrane Central Register of Controlled Trials were searched.
Received: October 17, 2024 Results: Four randomized clinical trials (RCTs) and six prospective observational
studies were included. Rates of cancer diagnosis at initial screening and during the
Revised: February 12, 2025
follow-up in RCTs differed statistically between the two groups (odds ratio [OR]:
Accepted: May 19, 2025 2.28 [95% confidence interval (CI): 1.37 ‒ 3.82; p<0.001] vs. OR: 0.35 [95% CI: 0.16 ‒
Published online: June 16, 2025 0.77; p<0.001], respectively). The analysis of the RTCs indicated early-stage cancer
at diagnosis in an extensive screening group, with results statistically significant
Copyright: © 2025 Author(s).
This is an Open-Access article (OR: 8.5; 95% CI: 2.57 ‒ 28.17; p<0.001). No differences were observed in cancer-
distributed under the terms of the related mortality (OR: 1.07; 95% CI: 0.57 ‒ 2.00; p=0.143) and overall mortality (OR:
Creative Commons AttributionNon- 0.80; 95% CI: 0.44 ‒ 1.45; p=0.567) at the end of follow-up. Conclusion: Extensive
Commercial 4.0 International (CC
BY-NC 4.0), which permits all testing for undiagnosed cancer in people with a first episode of unprovoked VTE
non-commercial use, distribution, does not reduce cancer-related mortality. Relevance for Patients: This study
and reproduction in any medium, supports tailored cancer screening in VTE patients, potentially reducing harm from
provided the original work is
properly cited. overtesting and improving clinical outcomes.
Publisher’s Note: AccScience
Publishing remains neutral with Keywords: Early detection screening; Occult malignancy; Risk; Systematic review; Venous
regard to jurisdictional claims in
published maps and institutional thromboembolism
affiliations.

Volume 11 Issue 4 (2025) 3 doi: 10.36922/jctr.24.00069