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The increased risk of venous thromboembolism by advancing age cannot be attributed to the higher incidence of cancer in the elderly: the Tromsø study

Abstract

Whether the high incidence of venous thromboembolism (VTE) in the elderly can be attributed to cancer is not well studied. We assessed the impact of cancer on risk of VTE in young, middle-aged and elderly. 26,094 subjects without a history of cancer or VTE were recruited from the Tromsø study. Incident cancer (n = 2,290) and VTE (n = 531) were recorded from baseline (1994–1995) through December 31st, 2009. Cox regression with cancer as time-varying exposure was used to calculate hazard ratios with 95 % confidence intervals (CI). Overt cancer was associated with a fivefold (95 %CI 4.3, 6.7) increased risk of VTE, with an age-dependent gradient from 26-fold (95 %CI 12.1, 56.5) increased in the young, ninefold (95 % CI 6.6, 12.7) increased in the middle-aged, and threefold (95 % CI 2.5, 4.5) increased risk in the elderly. The population attributable risks were 14, 27 and 18 %, respectively. Conclusion: The relative risk of VTE by cancer were higher in young compared to elderly subjects, but the proportion of VTEs in the population due to cancer did not differ much across age groups. Our findings indicate that the increased risk of VTE by advancing age cannot be attributed to higher incidence of cancer in the elderly.

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Acknowledgments

The authors received grants from the Northern Norway Regional Health Authority (SK Brækkan and JB Hansen) and the Tom Wilhelmsen Foundation (K Blix). KB, SKB and JBH were involved in acquisition of the data, concept and design of the study, data analysis, interpretation of results and drafting the manuscript. SleC was involved in data analysis, interpretation and critical revision of the manuscript. FES and SCC contributed to interpretation of the results and critical revision of the manuscript. All authors approved the final version of the manuscript.

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The authors declare that they have no conflict of interest.

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Correspondence to Kristine Blix.

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Blix, K., Brækkan, S.K., le Cessie, S. et al. The increased risk of venous thromboembolism by advancing age cannot be attributed to the higher incidence of cancer in the elderly: the Tromsø study. Eur J Epidemiol 29, 277–284 (2014). https://doi.org/10.1007/s10654-014-9902-7

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Keywords

  • Venous thromboembolism
  • Cancer
  • Age groups
  • Cohort study
  • Attributable risk