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World J Methodol. Jun 20, 2026; 16(2): 110380
Published online Jun 20, 2026. doi: 10.5662/wjm.v16.i2.110380
Published online Jun 20, 2026. doi: 10.5662/wjm.v16.i2.110380
Direct oral anticoagulants vs LMWH for cancer-associated thrombosis - updated evidence on bleeding risk, recurrence and patient-reported outcomes: A systematic review
Duaa Asad, Department of Medicine, Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trust, Portsmouth PO6 3 LY, United Kingdom
Ahris Abid, Department of Medicine, Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough PE3 9GZ, United Kingdom
Muhammad Bari Hassan, Munesh Kumar Nenwani, Fnu Sapna, Payal Bai, Department of Medi
Sunil Dev, Department of Medicine, Liaquat National Hospital and Medical College, Karachi 74800, Sindh, Pakistan
Sanjeet Kumar, Department of Medicine, Bilawal Medical College, Affiliated with Liaquat University of Medical and Health Sciences, Jamshoro 76090, Sindh, Pakistan
Sadia Siddique, Department of Medicine, Faisalabad Medical University, Faisalabad 37610, Punjab, Pakistan
Inshal Jawed, Department of Medicine, Dow University of Health Sciences, Karachi 75350, Sindh, Pakistan
Farah Alam, Department of Medicine, DOW Medical College, Karachi 75280, Sindh, Pakistan
Farah Abdul Razzaq, Department of Medicine, Civil Hospital, Karachi 74000, Sindh, Pakistan
Favour C Mekowulu, Department of Medicine, Specialist practice for Cardiology and Pulmo
Shafaq Jabeen, Department of Medicine, Karachi Dental and Medical College, Karachi 74700, Sindh, Pakistan
Agha MW Mirza, Department of Medicine, Jinnah Medical and Dental College, Karachi 74800, Sindh, Pakistan
Co-first authors: Duaa Asad and Ahris Abid.
Author contributions: Asad D, Abid A, Bari Hassan M, Nenwani MK, Dev S, Kumar S, Sapna F, Bai P, Siddique S, Jawed I, Alam F, Razzak FA, Mekowulu FC, Jabeen S, Mirza AM designed the research study; Asad D, Abid A, Bari Hassan M, Nenwani MK, Dev S, Kumar S, Sapna F, Bai P, Siddique S, Jawed I, Alam F, Razzak FA, Mekowulu FC, Jabeen S, Mirza AM performed the research; Asad D, Abid A, Bari Hassan M, Nenwani MK, Dev S, Kumar S, Sapna F, Bai P, Siddique S, Jawed I, Alam F, Razzak FA, Mekowulu FC, Jabeen S, Mirza AM contributed new reagents and analytic tools; Asad D, Abid A, Bari Hassan M, Nenwani MK, Dev S, Kumar S, Sapna F, Bai P, Siddique S, Jawed I, Alam F, Razzak FA, Mekowulu FC, Jabeen S, Mirza AM analyzed the data and wrote the manuscript. Asad D and Abid A contributed equally to this work.
Conflict-of-interest statement: The authors declare no conflicts of interest or financial interests related to the content of this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Inshal Jawed, Chief Physician, Senior Researcher, Department of Medicine, Dow University of Health Sciences, Baba-e-urdu Karachi, Karachi 75350, Sindh, Pakistan. inshaljwd@gmail.com
Received: June 6, 2025
Revised: July 7, 2025
Accepted: October 21, 2025
Published online: June 20, 2026
Processing time: 322 Days and 13.3 Hours
Revised: July 7, 2025
Accepted: October 21, 2025
Published online: June 20, 2026
Processing time: 322 Days and 13.3 Hours
Core Tip
Core Tip: Patients with cancer, direct oral anticoagulants (DOACs) are effective, as are low-molecular-weight heparin, in preventing new blood clots. DOACs raise the risk of bleeding, mainly in the digestive tract and urinary organs. Patients choose DOACs since they improve their quality of life and are convenient. Doctors have to consider the cancer type, possibility of bleeding and platelet levels before deciding on the treatment. Taking into account what the patient wants and what the medical team considers best is necessary. Anticoagulation treatment can be improved in multidisciplinary thrombosis programs, emphasizing the importance of providing ongoing information and support to patients.