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No increased incidence of cancer in patients with superficial phlebitis

Clinical Question:
Are patients with superficial thrombophlebitis at increased risk of developing cancer in the next 2 years?

Bottom Line:
In primary care settings, patients with a clinical diagnosis of superficial venous thrombophlebitis have the same 2-year rate of developing cancer (2%) as matched control patients. (LOE = 1b-)

Reference:
van Doormaal FF, Atalay S, Brouwer HJ, van der Velde EF, Büller HR, van Weert HC. Idiopathic superficial thrombophlebitis and the incidence of cancer in primary care patients. Ann Fam Med 2010;8(1):47-50.  [PMID:20065278]

Study Design:
Cohort (prospective)

Setting:
Outpatient (primary care)

Synopsis:
In this Dutch, primary care, practice-based network linked with an electronic medical record (EMR) system, patients with a primary clinical diagnosis of superficial venous thrombophlebitis were observed for up to 2 years after diagnosis. For each patient with phlebitis, the researchers identified 2 control patients matched for sex, age, and family physician. Patients with a known diagnosis of cancer at baseline, patients with phlebitis associated with intravenous catheters, and those with recent surgery were excluded from the study. The researchers assumed that since 94% of all health problems in the Netherlands are treated by family physicians that a serious diagnosis like cancer would certainly appear in the EMR. Although this may be true, it would have been better to have this validated by a supplemental search of disease registries or other administrative data. The authors included 277 patients with phlebitis and 553 control patients. At baseline, 10% of the afflicted patients had an established diagnosis of cancer compared with 9% of the control patients. Among patients without an established diagnosis of cancer, 2% of the patients in each group were subsequently diagnosed after 2 years. They did not have complete follow-up data on 12% of the afflicted patients and 15% of the control patients. This incomplete follow-up is a potential threat to this data.

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