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ACP Journal Club |17 November 2015

Adding CT to screening for occult cancer did not increase diagnosis of cancer from screening in unprovoked VTE

Richard Schreiber, MD, FACP

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Carrier M, Lazo-Langner A, Shivakumar S, et al; SOME Investigators. Screening for occult cancer in unprovoked venous thromboembolism. N Engl J Med. 2015;373:697-704. 26095467

GIM/FP/GP:

Hematol/Thrombo:

Oncology:

In patients with a first unprovoked venous thromboembolism (UVTE), does adding comprehensive computed tomography (CT) to age and sex-specific limited screening for occult cancer increase the rate of occult cancer diagnosis?
Randomized controlled trial (RCT) (Screening for Occult Malignancy in Patients with Idiopathic Venous Thromboembolism [SOME] trial). ClinicalTrials.gov NCT00773448.
Concealed.*
Blinded* (outcome adjudicators).
1 year.
9 clinical centers in Canada.
862 adults ≥ 18 years of age (mean age 54 y, 67% men) who had a first symptomatic UVTE. Exclusion criteria included creatinine clearance (CrCl) < 60 mL/min, allergy to contrast media, weight > 130 kg, ulcerative colitis, glaucoma, claustrophobia, or agoraphobia.
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Schreiber R. Adding CT to screening for occult cancer did not increase diagnosis of cancer from screening in unprovoked VTE. Ann Intern Med. ;163:JC9. doi: 10.7326/ACPJC-2015-163-10-009

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Published: Ann Intern Med. 2015;163(10):JC9.

DOI: 10.7326/ACPJC-2015-163-10-009

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