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Peer-reviewedCC BYCancer Medicine

Prevention of Venous Thromboembolism in Patients With Pancreatic Cancer: A Nationwide Survey

  • Ruth A. L. Willems1
  • Merlijn U. J. E. Graus1
  • Eline H. E. vanGansewinkel1
  • Aniek E. vanDiepen1
  • Geert A. Cirkel2
  • Hanneke W. M. vanLaarhoven3
  • Miriam L. Wumkes4
  • Marjolein Y. V. Homs5
  • Johanna W. Wilmink3
  • F. A. Klok6
  • Nick vanEs7
  • Hugo tenCate8
2 more authors
  • Judith deVos‐Geelen1
  • for the Dutch Pancreatic Cancer Group (DPCG)
8 affiliations
  1. 1Department of Internal Medicine, Division of Medical Oncology Maastricht University Medical Center Maastricht the Netherlands
  2. 2Department of Medical Oncology, Regional Academic Cancer Center Utrecht, Antonius University Medical Center Utrecht Utrecht the Netherlands
  3. 3Cancer Center Amsterdam Cancer Treatment and Quality of Life Amsterdam the Netherlands
  4. 4Department of Medical Oncology Jeroen Bosch Hospital ‘s‐Hertogenbosch the Netherlands
  5. 5Department of Medical Oncology Erasmus MC Cancer Institute Rotterdam the Netherlands
  6. 6Department of Medicine‐Thrombosis and Hemostasis Leiden University Medical Center Leiden the Netherlands
  7. 7Department of Vascular Medicine University of Amsterdam, Amsterdam UMC Location Amsterdam the Netherlands
  8. 8Thrombosis Expert Center Maastricht Maastricht University Medical Center Maastricht the Netherlands
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Abstract

Background Pancreatic cancer is associated with a high risk of venous thromboembolism (VTE), with approximately one in five patients developing VTE. Randomized controlled trials have demonstrated that primary thromboprophylaxis is effective and safe in ambulatory patients with pancreatic cancer treated with chemotherapy. Despite international guideline recommendations, thromboprophylaxis appears underused in clinical practice. Objectives To assess clinical practice regarding VTE prevention in ambulatory patients with pancreatic cancer among medical oncologists in the Netherlands. Methods A nationwide online survey was conducted between March and June 2025 among Dutch medical oncologists involved in pancreatic cancer care. The questionnaire assessed VTE risk perception, use of risk assessment tools, use of thromboprophylaxis, and patient education regarding thrombosis. Results Thirty‐eight medical oncologists completed the survey. Most respondents (79%) classified the VTE risk in patients with pancreatic cancer as high or very high, yet 63% never prescribed thromboprophylaxis to ambulatory patients receiving chemotherapy. Lack of a national guideline recommendation was the most frequently reported reason for not prescribing thromboprophylaxis (74%). Only 11% of medical oncologists reported using the Khorana score, and only 3% always discussed VTE risk with patients. Conclusion Although medical oncologists recognize the high risk of VTE in patients with pancreatic cancer, thromboprophylaxis remains substantially underused in clinical practice in the Netherlands. Limited awareness of risk assessment tools and national guidance were prominent findings that may inform future implementation efforts. These findings provide a benchmark for assessing the impact of the recently updated Dutch guideline on thromboprophylaxis in this high‐risk population.

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Cite

BibTeXRIS
BibTeX
@article{willems2026prevention,
  title = {{Prevention of Venous Thromboembolism in Patients With Pancreatic Cancer: A Nationwide Survey}},
  author = {Ruth A. L. Willems and Merlijn U. J. E. Graus and Eline H. E. vanGansewinkel and Aniek E. vanDiepen and Geert A. Cirkel and Hanneke W. M. vanLaarhoven and Miriam L. Wumkes and Marjolein Y. V. Homs and Johanna W. Wilmink and F. A. Klok and Nick vanEs and Hugo tenCate and Judith deVos‐Geelen and for the Dutch Pancreatic Cancer Group (DPCG)},
  journal = {Cancer Medicine},
  year = {2026},
  month = oct,
  doi = {10.1002/cam4.72306},
  url = {https://doi.org/10.1002/cam4.72306},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Prevention of Venous Thromboembolism in Patients With Pancreatic Cancer: A Nationwide Survey
AU  - Ruth A. L. Willems
AU  - Merlijn U. J. E. Graus
AU  - Eline H. E. vanGansewinkel
AU  - Aniek E. vanDiepen
AU  - Geert A. Cirkel
AU  - Hanneke W. M. vanLaarhoven
AU  - Miriam L. Wumkes
AU  - Marjolein Y. V. Homs
AU  - Johanna W. Wilmink
AU  - F. A. Klok
AU  - Nick vanEs
AU  - Hugo tenCate
AU  - Judith deVos‐Geelen
AU  - for the Dutch Pancreatic Cancer Group (DPCG)
PY  - 2026
DA  - 2026/10/24
JO  - Cancer Medicine
DO  - 10.1002/cam4.72306
UR  - https://doi.org/10.1002/cam4.72306
AB  - Background Pancreatic cancer is associated with a high risk of venous thromboembolism (VTE), with approximately one in five patients developing VTE. Randomized controlled trials have demonstrated that primary thromboprophylaxis is effective and safe in ambulatory patients with pancreatic cancer treated with chemotherapy. Despite international guideline recommendations, thromboprophylaxis appears underused in clinical practice. Objectives To assess clinical practice regarding VTE prevention in ambulatory patients with pancreatic cancer among medical oncologists in the Netherlands. Methods A nationwide online survey was conducted between March and June 2025 among Dutch medical oncologists involved in pancreatic cancer care. The questionnaire assessed VTE risk perception, use of risk assessment tools, use of thromboprophylaxis, and patient education regarding thrombosis. Results Thirty‐eight medical oncologists completed the survey. Most respondents (79%) classified the VTE risk in patients with pancreatic cancer as high or very high, yet 63% never prescribed thromboprophylaxis to ambulatory patients receiving chemotherapy. Lack of a national guideline recommendation was the most frequently reported reason for not prescribing thromboprophylaxis (74%). Only 11% of medical oncologists reported using the Khorana score, and only 3% always discussed VTE risk with patients. Conclusion Although medical oncologists recognize the high risk of VTE in patients with pancreatic cancer, thromboprophylaxis remains substantially underused in clinical practice in the Netherlands. Limited awareness of risk assessment tools and national guidance were prominent findings that may inform future implementation efforts. These findings provide a benchmark for assessing the impact of the recently updated Dutch guideline on thromboprophylaxis in this high‐risk population.
SN  - 2045-7634
ER  -