Related Experiment Video
Updated: May 28, 2026
A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
Published on: January 19, 2024
Endoscopy underuse for new-onset iron deficiency anemia in younger veterans
Andrew J Read1, Sarah L Krein2,3, Kennedy DuBose3
1Department of Internal Medicine, Institute for Healthcare Policy and Innovation, and Rogel Cancer Institute, University of Michigan, 3912 Taubman Center, 1500 E Medical Center Dr, SPC 5362, Ann Arbor, MI 48109-5362.
Objectives:
Bidirectional endoscopy is recommended for new-onset iron deficiency anemia (IDA), given the risk of gastrointestinal (GI) cancer. The rate of endoscopic assessment in younger patients is unknown.
Study Design:
Retrospective cohort study.
Methods:
We assessed US veterans younger than 45 years with new-onset IDA and their outcomes of endoscopy within 1 year.
Results:
There was a low rate of bidirectional endoscopy in this population (9.58% within 1 year). Predictors of undergoing any endoscopic evaluation included male sex (OR, 5.13; 95% CI, 4.55-5.78) and hemoglobin level (OR, 0.76 per 1-unit increase; 95% CI, 0.72-0.80).
Conclusions:
Given low current rates of bidirectional endoscopic evaluation in this population, implementation of bidirectional endoscopy in all individuals with IDA would require significantly increased resources. Further study of this population is needed to determine the impact of the 2020 American Gastroenterological Association guidelines on endoscopic use and GI cancer diagnoses.
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