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X-ChEXIT in screening for occult cancer in patients with a deep vein thrombosis

Published:April 17, 2017DOI:https://doi.org/10.1016/j.ejim.2017.04.007
      Recently there has been a lot of debate about how extensive the screening for occult cancer in patients with a deep vein thrombosis (DVT) should be. Cornuz et al. was one of the first to suggest that a limited screening comprising of a comprehensive medical history, physical examination (including breast and rectal examination), routine laboratory tests and chest X-ray (CXR), is an appropriate screening for occult cancer in patients with idiopathic deep vein thrombosis (iDVT) [
      • Cornuz J.
      • Pearson S.D.
      • Creager M.A.
      • Cook E.F.
      • Goldman L.
      Importance of findings on the initial evaluation for cancer in patients with symptomatic idiopathic deep venous thrombosis.
      ]. Extensive screening with computed tomography (CT) scans did not seem to detect more occult cancer in patients with iDVT or give any profit in cancer-related mortality rates, in comparison with the limited screening [
      • Carrier M.
      • Lazo-Langner A.
      • Shivakumar S.
      • et al.
      Screening for occult cancer in unprovoked venous thromboembolism.
      ,
      • Prandoni P.
      • Bernardi E.
      • Valle F.D.
      • et al.
      Extensive computed tomography versus limited screening for detection of occult cancer in unprovoked venous thromboembolism: a multicenter, controlled, randomized clinical trial.
      ]. To this day, in our hospital, we still apply this limited combination of diagnostics to detect occult cancer in all patients diagnosed with a DVT. A CXR, breast- and rectal examination is only performed in patients over 40 years of age. The purpose of this study was to evaluate if the CXR is of any additive value in this screening for occult cancer.
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