Iron-deficiency anemia is common and may be caused by blood loss from gastrointestinal tumours.
Dr Martin James and colleagues defined risk factors for gastrointestinal malignancy in patients with Iron-deficiency anemia.
Patients with suspected Iron-deficiency anemia referred for gastrointestinal investigations were prospectively identified.
The patients were included between 1998 and 1999 from 2 neighbouring UK hospitals serving a population of 550,000 patients.
Final diagnoses were determined after 2 years.
The researchers then compared those patients with and without gastrointestinal cancer as a cause for their iron-deficiency anemia.
Data collected included sex, age, haemoglobin, serum ferritin, mean cell volume and drug history.
|Gastrointestinal cancer was diagnosed in 11% of patients with iron-deficiency anemia|
|Journal of Gastroenterology & Hepatology|
The research team investigated a total of 695 patients, of which 236 were men with a mean age of 69 years, and 459 women with a mean age of 66 years.
All patients presented with iron-deficiency anemia.
The team diagnosed malignancy in 13% and gastrointestinal malignancy in 11%.
The team found that the most frequently diagnosed cancers were colonic at 6%, gastric occurring in 4%, and renal tract in 1% of patients.
The adjusted odds ratio for gastrointestinal cancer as a cause of iron-deficiency anemia was significantly higher for male sex, and age over 50 years.
The researchers also noted that hemoglobin level at presentation had higher odds ratios for gastrointestinal cancer as a cause of iron-deficiency anemia.
There was no significant difference in gastrointestinal malignancy in those taking aspirin, and non-aspirin drugs compared with those not taking the drugs.
The team found no difference in gastrointestinal malignancy with non-steroidal anti-inflammatory drugs or warfarin compared with not taking these drug.
No cause for iron-deficiency anemia was found in 54%.
Dr James' team commented, “Cancer was diagnosed in 13% and gastrointestinal cancer in 11% of patients with iron-deficiency anemia.”
“Significant risk factors for gastrointestinal malignancy in iron-deficiency anemia patients are male sex, age over 50 years and haemoglobin at presentation.”
“Iron-deficiency anemia should not be attributed to aspirin, non-steroidal anti-inflammatory drugs or warfarin use.”