Iron deficiency anaemia--useful diagnostic tool for right sided colon cancers?

Diagnosis of right-sided colon cancers requires total colonic imaging. The decision as to when a symptomatic patient should undergo a complete colonic imaging is difficult. It has been suggested that the presence of iron deficiency anaemia in such patients can be a useful tool in making that decision, as the vast majority of proximal colon cancers are anaemic. Our study aimed to evaluate the relation between proximal colon cancers and anaemia.

A list of 194 patients who underwent a right hemicolectomy for colon cancer was extracted from our hospital cancer database. The haemoglobin levels of each of these patients at the time of their referral were identified. The proportion of these patients, who had anaemia as per locally agreed guidelines, was determined.

Only 44% of the men and 57% of women with proximal colon cancer were found to be anaemic. Even after using higher cut-off levels for 'low' haemoglobin, a significant proportion of patients were not anaemic.

Anaemia is a poor predictor of right-sided colon cancers and cannot be used as an effective investigative tool in symptomatic patients.