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. 2022 Jan 4;5(1):e2141633.
doi: 10.1001/jamanetworkopen.2021.41633.

Analysis of Platelet Count and New Cancer Diagnosis Over a 10-Year Period

Vasily Giannakeas  1   2   3 , Joanne Kotsopoulos  1   2 , Matthew C Cheung  3   4 , Laura Rosella  2 , Jennifer D Brooks  2 , Lorraine Lipscombe  1   3   5   6 , Mohammad R Akbari  1   2   7 , Peter C Austin  3   8 , Steven A Narod  1   2   7
Affiliations

Analysis of Platelet Count and New Cancer Diagnosis Over a 10-Year Period

Vasily Giannakeas et al. JAMA Netw Open. .

Abstract

Importance: Individuals with cancer often have an elevated platelet count at the time of diagnosis. The extent to which an elevated platelet count is an indicator of cancer is unclear.

Objective: To evaluate the association of an elevated platelet count with a cancer diagnosis.

Design, setting, and participants: This nested case-control study included Ontario residents enrolled in the provincial health insurance plan who had 1 or more routine complete blood count (CBC) tests performed between January 1, 2007, and December 31, 2017, with follow-up through December 31, 2018. Case patients were individuals with a new cancer diagnosis during the observation period. Eligible control individuals were cancer free before the date of diagnosis for a case patient to whom they were matched. One case patient was matched to 3 controls based on sex, age, and health care use patterns. Data were analyzed from September 24, 2020, to July 13, 2021.

Exposures: Case patients and controls were assigned to 1 of 5 exposure groups based on age- and sex-specific platelet count distributions in the control population: very low (≤10th percentile), low (>10th to 25th percentile), medium (>25th to <75th percentile), high (75th to <90th percentile), and very high (≥90th percentile).

Main outcomes and measures: Odds ratios (ORs) were estimated for specific cancer sites for each category of platelet count at intervals up to 10 years after a blood test.

Results: Of the 8 917 187 eligible Ontario residents with a routine CBC record available, 4 971 578 (55.8%) were women; the median age at the first CBC was 46.4 years (IQR, 32.5-59.5 years). Among individuals with a routine CBC record available, 495 341 (5.6%) received a diagnosis of first primary cancer during the 10-year observation period. The OR for a solid tumor diagnosis associated with a very high platelet count vs a medium platelet count in the 6-month period before the diagnosis was 2.32 (95% CI, 2.28-2.35). A very high platelet count was associated with colon (OR, 4.38; 95% CI, 4.22-4.54), lung (OR, 4.37; 95% CI, 4.22-4.53), ovarian (OR, 4.62; 95% CI, 4.19-5.09), and stomach (OR, 4.27; 95% CI, 3.91-4.66) cancers. Odds ratios attenuated with increasing time from CBC test to cancer diagnosis.

Conclusions and relevance: In this nested case-control study, an elevated platelet count was associated with increased risk of cancer at several sites. Our findings suggest that an elevated platelet count could potentially serve as a marker for the presence of some cancer types.

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Conflict of interest statement

Conflict of Interest Disclosures: Mr Giannakeas reported receiving financial support through the Canadian Institutes of Health Research Frederick Banting and Charles Best Doctoral Research Award during the conduct of the study. Dr Lipscombe reported receiving grants from the Canadian Institutes of Health Research, personal fees from Diabetes Canada, and salary support from the University of Toronto Novo Nordisk Network for Healthy Populations outside the submitted work. Dr Austin reported receiving financial support through a Mid-Career Investigator Award from the Heart and Stroke Foundation. Dr Narod reported being a recipient of the tier I Canada Research Chair in Breast Cancer. Dr Kotsopoulos reported being a recipient of a tier II Canada Research Chair. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Odds Ratios of Cancer by Platelet Count Category and Time From Complete Blood Count Test to Cancer Diagnosis
Figure 2.
Figure 2.. Odds Ratios of Colon Cancer by Platelet Count Category and Time From Complete Blood Count Test to Cancer Diagnosis by Cancer Stage
Figure 3.
Figure 3.. Odds Ratios of Cancer by Change in Platelet Count Category and Time From Complete Blood Count Test to Diagnosis
See this image and copyright information in PMC

References

    1. Tefferi A. Approach to the patient with thrombocytosis. UpToDate. 2020. Accessed May 19, 2021. https://www.uptodate.com/contents/approach-to-the-patient-with-thrombocy...
    1. Segal JB, Moliterno AR. Platelet counts differ by sex, ethnicity, and age in the United States. Ann Epidemiol. 2006;16(2):123-130. doi: 10.1016/j.annepidem.2005.06.052 - DOI - PubMed
    1. Harrison CN, Bareford D, Butt N, et al. ; British Committee for Standards in Haematology . Guideline for investigation and management of adults and children presenting with a thrombocytosis. Br J Haematol. 2010;149(3):352-375. doi: 10.1111/j.1365-2141.2010.08122.x - DOI - PubMed
    1. Stone RL, Nick AM, McNeish IA, et al. Paraneoplastic thrombocytosis in ovarian cancer. N Engl J Med. 2012;366(7):610-618. doi: 10.1056/NEJMoa1110352 - DOI - PMC - PubMed
    1. Schafer AI. Thrombocytosis. N Engl J Med. 2004;350(12):1211-1219. doi: 10.1056/NEJMra035363 - DOI - PubMed

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