Research Year Student, Medical Student Department of Clinical Epidemiology, Aarhus University, Denmark
Background: We aim to investigate whether a history of a thromboembolic event (VTE) and/or anticoagulant use at time of renal cell carcinoma (RCC) diagnosis affects stage distribution for patients undergoing surgical treatment.
Methods: We conducted a nationwide cross-sectional study of RCC patients undergoing surgical treatment druing 2009-2020 in Denmark. We used Danish population-based health registries to retrieve information on anticoagulant prescriptions, previous VTEs, and baseline characteristics.
Crude and adjusted prevalence rate ratios (PRR) were computed for each disease stage using linear regression with adjustment for potential confounders including sex, age, marital status, comorbidities, type of operation and diagnostic codes for alcoholism, hypertension, and autoimmune diseases.
Results: Among 4384 patients diagnosed with RCC undergoing surgical treatment, 1080 were current anticoagulant users (redemption of at least one prescription within 3 months prior to treatment), and had a slightly higher probability of being diagnosed at stage I (PRR 1.10 [0.98-1.22]) compared to stage II (PRR 0.78 [0.56-1.05]) and stage III (PRR 0.97 [0.84-1.12]). A similar pattern was found among the 462 identified as former anticoagulant users (redemption of at least one prescription between 5 years to 3 months prior to treatment) (stage I: PRR 1.11 [0.97-1.27], stage II: PRR 0.73 [0.57-0.93] and stage III: 0.94 [0.77-1.13]). The same accounts for the 140 patients with a history of VTE (stage I: PRR 1.07 [0.85-1.32 and stage II: PRR 0.55 [0.26-1.01]).
Conclusions: Our analyses suggest a tendency for all three groups to be diagnosed at an earlier disease stage, possibly explained by their increased risk of bleeding, prompting diagnosis.