Alimited cancer screening strategy, including basic blood testing without a CT scan, is adequate for detection of occult cancer in patients with a first unprovoked venous thromboembolism (VT), according to a study published June 22 in the New England Journal of Medicine. An unprovoked VT (as opposed to a deepvein thrombosis or pulmonary embolism tied to a transient risk factor like trauma, surgery, prolonged immobility, or pregnancy) may be an early sign of cancer. Previous studies estimate that as many as 10 percent of patients with an unprovoked VT receive a cancer diagnosis in the year following VT and unprovoked cases represent more than 40 percent of all VTs. Clinicians and payers have struggled with how aggressively to screen for occult cancers in these patients with unprovoked VT. In the current multicenter, Canadian trial, researchers randomized 854 patients with a new diagnosis of first unprovoked symptomatic VT to receive either limited occult cancer screening (including medical history, physical exam, complete blood counts, serum electrolyte and creatinine levels, liver-function testing, and a chest x-ray) or extensive screening with the addition of a CT of the abdomen and pelvis. Additional sex-specific testing (mammography, Papanicolaou, and prostate-specific antigen) occurred for those not up-to-date […]