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 23 May 2018

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Gastrointestinal cancer risk with iron-deficiency anemia

Risk factors include male sex, age over 50 years and haemoglobin at presentation, and iron-deficiency anemia should not be attributed to aspirin, non-steroidal anti-inflammatory drugs or warfarin use, reports the latest issue of the European Journal of Gastroenterology & Hepatology.

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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.”

Eur J Gastroenterol Hepatol 2005: 17(11): 1197-1203
20 October 2005

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