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Curative resectability of gastrointestinal cancer identified from iron deficiency anemia
Kenta Kawasaki1,2, Yasuo Hamamoto3, Masayasu Horibe2
1Department of Gastroenterology, Asahi General Hospital, Asahi, Chiba 289-2511, Japan.
Insights
Iron deficiency anemia (IDA) in adults can indicate gastrointestinal cancer. Early detection through gastroscopy and colonoscopy allows for curative treatment in over half of diagnosed patients.
Area of Science:
- Gastroenterology
- Oncology
- Internal Medicine
Background:
- Iron deficiency anemia (IDA) is a common condition with diverse causes.
- Undiagnosed gastrointestinal cancers can present as IDA, particularly in older adults.
- Timely diagnosis and staging are crucial for effective cancer treatment.
Purpose of the Study:
- To investigate the prevalence and staging of gastrointestinal cancers in patients diagnosed with IDA.
- To assess the curability and treatment outcomes of these cancers.
- To highlight the importance of investigating IDA as a potential cancer symptom.
Main Methods:
- Retrospective analysis of patients diagnosed with IDA (hemoglobin <135 g/l males, <120 g/l females; ferritin <33.71 pmol/l).
- Inclusion of patients aged >51 years (females) and >18 years (males) from Asahi General Hospital (2010-2012).
- Endoscopic procedures (gastroscopy and/or colonoscopy) were performed on a subset of patients to identify malignancies.
Main Results:
- Malignancies were detected in 50 out of 472 IDA patients (10.6%).
- Gastric cancer (24 patients) and colorectal cancer (23 patients) were the most common diagnoses.
- Stages ranged from I to IV for gastric cancer and II to IV for colorectal cancer; curative surgery was performed on over 50% of patients with stage III or lower malignancies.
Conclusions:
- IDA is a significant indicator for gastrointestinal cancer in adults.
- Endoscopic investigation of IDA patients can lead to early cancer detection.
- A substantial proportion of gastrointestinal cancers presenting as IDA are amenable to curative treatment.
Abstract:
The present study aimed to clarify the staging and curative resectability of gastrointestinal cancer found through iron deficiency anemia (IDA). An electronic database was used and females >51 and males >18 years old were identified who had been diagnosed with IDA at the internal medicine outpatient clinic of Asahi General Hospital (Chiba, Japan) from 1 April 2010 to 31 March 2012. IDA was defined as a hemoglobin level of <135 g/l for males and <120 g/l for females, combined with a serum ferritin level of <33.71 pmol/l. Of the 472 patients who had been diagnosed with IDA, 347 patients underwent either a gastroscopy and/or colonoscopy, including 120 patients who had undergone both gastroscopy and colonoscopy, 197 patients who only underwent gastroscopy, and 30 patients who only underwent colonoscopy. In total, 125/472 patients diagnosed with IDA did not undergo a gastroscopy or a colonoscopy. From the 50 patients who were diagnosed with cancer as a result of the investigation, 24 patients had gastric cancer and 23 patients had colorectal cancer. Of the gastric cancer patients, 6 patients were stage I, 3 patients stage II, 5 patients were stage III and 9 patients were stage IV. In colorectal cancer, 9 patients were stage II, 8 patients were stage III and 4 patients were stage IV. Curative surgery including endoscopic treatment was performed on 14 gastric cancer patients and 17 colorectal cancer patients of stage III or lower. Malignancies were found in 50 patients with IDA, and curative surgery was performed on >50% of the patients.
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