Pulmonary origin and risk assessment of cancer-associated thrombosis

Cancer-associated thrombosis (CAT) is a serious complication frequently observed in patients with cancer; however, its exact mechanism is not yet fully understood. Recent research in 2025 suggests that the lungs play a significant role in providing prothrombotic factors. Both primary and metastatic lung tumors have the potential to induce a state of hypercoagulability through various pathways, such as the secretion of procoagulant molecules, such as tissue factor (TF), triggering local inflammatory responses, platelet activation, and alterations in the function of vascular endothelial cells. Furthermore, the unique network of blood vessels and haemodynamic conditions in the lungs may contribute to the formation of thrombosis. Understanding the specific mechanisms by which lung cancer can lead to thrombosis is crucial for the early detection and intervention of CAT. This review delves into the intricate relationship between the tumor microenvironment in the lungs and the development of thrombosis, exploring the underlying molecular pathways involved in this relationship. By examining the prevention and treatment strategies for CAT currently used in clinical practice, with a focus on lung cancer-induced thrombosis, this review aims to establish a solid foundation for clinical management of these conditions. This review explores the relationship between lung cancer and thrombosis, focusing on the interaction of the tumor microenvironment, inflammatory factors, and coagulation abnormalities in creating a unique pathophysiological process in the lungs. Previous reviews have not addressed this specific aspect. By incorporating the latest research findings, this review suggests the use of lung-specific biomarkers for early detection, risk assessment, and personalized anticoagulant therapy for CAT. Emphasizing the potential benefits of combining anticoagulant therapy with cancer treatment by summarizing and analyzing existing researches, providing a comprehensive overview of an area that has been lacking in systematic reviews.