The incidence of venous thromboembolism and its effect on survival among patients with primary bladder cancer

BACKGROUND: The incidence, risk factors, time course, and impact on survival of venous thromboembolism (VTE) in a large, population‐based study of patients with bladder cancer have not been identified previously. METHODS: The California Cancer Registry was merged with the California Patient Discharge Data Set to determine the incidence of VTE in patients with newly diagnosed bladder cancer within a 6‐year period. Cox proportional hazards models were used to determine the risk factors for VTE and the effects of VTE on survival. RESULTS: Among 24,861 patients with bladder cancer, the 2‐year incidence of VTE was 1.9%. The highest incidence of VTE occurred in the first 6 months regardless of age, sex, race, tumor stage, or histologic subtype. In a multivariate model, significant risk factors for the development of VTE included major surgery, advancing disease stage, and increasing number of comorbidities. Compared with the general population, the 1‐year standardized incidence ratio for VTE in the bladder cancer cohort was 5.3 (95% confidence interval, 4.8‐5.9). Among patients with bladder cancer, significant risk factors for death included advancing disease stage, increasing comorbidities, African‐American race, nontransitional cell carcinoma histology, and the development of VTE. CONCLUSIONS: Patients with bladder cancer had a 1.9% 2‐year incidence of VTE. Metastatic disease was the strongest predictor of both VTE and death. It was noteworthy that cancer‐associated surgery was associated with a higher risk of VTE, which differed from the results reported from other studies in solid tumors. VTE was a significant predictor of death in the first 2 years. Cancer 2010. © 2010 American Cancer Society. The authors investigated the incidence, risk factors, time course, and impact on survival of venous thromboembolism (VTE) in a large, population‐based study of patients with bladder cancer. A diagnosis of VTE after bladder cancer was identified as an independent risk factor for decreased survival within 2 years of bladder cancer diagnosis.