Venous thromboembolism (VTE) comprises of deep venous thrombosis (DVT) and pulmonary embolism (PE). This can be provoked by clinical risk factors such as recent major surgery, trauma, immobility, known malignancy, pregnancy or puerperium, smoking, obesity, underlying prothrombotic state or hormonal therapy. The term unprovoked DVT or PE is used when no such cause is identified (1). There is an increased risk of cancer in people with unprovoked VTE, which can be undiagnosed at presentation. The diagnosis of cancer in such patients has implications that different...

The audit was registered with audit department of our institution. As this was an audit with no intervention, formal ethics approval and individual patient consent was not required. A retrospective review of reports of all CT – Pulmonary angiogram (CT PA) done during the period from July 2019 to December 2019 in our institution was done. The positive cases were identified and were included in the audit. Patients with known underlying malignancy and other provoking factors were excluded. Patient’s demographics and comorbidities were collected and...

The total number of positive cases for pulmonary embolism over the study period was 166. The mean age was 66 (median 68, age range 22 to 101 years). Majority of the positive cases had provoking factors, of which, 31(19%) had known malignancy, 65(39%) had other provoking factors. Rest of them, 70(42%) were identified as unprovoked PE [Fig 1]. Most of the patients with unprovoked PE, 54(76%) had additional CT AP to look for occult cancer and 5(7%) had ultrasound for the same reason. However, 4...

Majority of cancer in the study cohort was detected in the CT PA examination and also some were detected in concurrent CT AP. The cancer detection rate on CT AP done following unprovoked PE to look for occult cancer was low, which is lower than other established studies (2.3%, 5.06%). This could be due to limitations by smaller data and not including Deep venous thrombosis (DVT) patients in the audit, although the NICE guidelines included both DVT and PE. Another limitation is that mammograms were...

1. National Institute for Health and Care Excellence. Venous thromboembolic diseases: diagnosis, management and thrombophilia testing. Published date: 26 March. NICE guideline (NG158); 2020. Available at:, https://www.nice.org.uk/guidance/ng158. Accessed 11 march 2020. 2. Venous thromboembolic diseases: diagnosis, management and thrombophilia testing [C] Evidence review for investigations for cancer in people with unprovoked venous thromboembolism NICE guideline NG158 Evidence review underpinning recommendations 1.8.1 and 1.8.2 in the guideline March 2020 3. Unprovoked venous thromboembolism in women over 40: is screening for occult malignancy with mammography and abdominopelvic...

I. RAJENDRAN: Nothing to disclose L. Tandon: Nothing to disclose