NICE recommends cancer tests for unexplained blood clots

BMJ 2012; 344 doi: (Published 27 June 2012) Cite this as: BMJ 2012;344:e4396
  1. Jacqui Wise
  1. 1London

Investigations for cancer should be carried out in patients aged over 40 who have a deep vein thrombosis or pulmonary embolism without an obvious cause, guidelines from the National Institute for Health and Clinical Excellence (NICE) recommend for the first time.

The recommendation has been made because the risk of blood clots is about four times greater in people with cancer than in those without. Cancer and thrombophilia are major risk factors for blood clots. Other risk factors include a history of deep venous thrombosis, age over 60 years, recent surgery or injury, obesity, prolonged travel, acute medical illness, immobility, and pregnancy.

Roshan Agarwal, a member of the Guideline Development Group and consultant medical oncologist at the Hammersmith Hospital, London, said: “One in 10 of all patients diagnosed with a blood clot has an underlying cancer. One in five cancer patients will …

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