Should Patients with Unprovoked Venous Thromboembolism Undergo CT of the Abdomen and Pelvis?

Venous thromboembolism (VTE) — mediated by a hypercoagulable state — can be a manifestation of cancer. However, we don't know whether screening for abdominal and pelvic cancer using computed tomography (CT) is worthwhile.

In this trial, Canadian researchers randomized 854 adults with VTE and no histories of cancer to active screening or usual care (controls). The control group received physical examinations, blood counts, chemistry panels, and chest radiography; the CT-screening group received all control evaluations and underwent an abdomen-pelvis CT protocol that included virtual gastroscopy and virtual colonoscopy. Chest CT was not included, because many patients already had undergone this test if they were evaluated for pulmonary embolis…