Occult cancers are frequent in patients with unprovoked venous thromboembolism (VTE) and approximately 10% of patients with unprovoked VTE will be diagnosed with cancer within one year of their thrombotic event. A “limited” occult cancer screening (medical history taking, physical examination, routine laboratory blood tests and a chest-X ray) detects a large proportion of these occult malignancies. A more extensive occult cancer screening strategy (computed tomography, ultrasound, tumor markers, etc) seems to increase the number of cancers detected. However, current evidence does not support improvements in malignancy-related mortality, morbidity or quality of life with an extensive cancer screening strategy. Further clinical trials are required to assess the risks and benefits of a comprehensive screening program in patients with unprovoked VTE.
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