Given that primary tumours commonly metastasise to the lung, and that levels of these thrombotic markers (along with levels of HIF1α and HIF2α) accurately predict distant metastasis-free survival, we propose that thrombosis-induced increases in HIF1 and HIF2 activation could also promote metastasis in cancer patients (Bos et al., 2001, 2003; Bouchet et al., 1994; Foekens et al., 1994; Grøndahl-Hansen et al., 1993, 1997; Helczynska et al., 2008; Janicke et al., 1993; Malmstrom et al., 2001). The gene discussed is EPAS1; the disease is cancer.