Anemia in patients with colorectal cancer

Abstract

Although anemia is one of the signs of colorectal cancer, the relationships between histological findings and hematological findings other than hemoglobin level have not been adequately investigated. We investigated the relationship between hematological findings, serum iron, and histological findings in 358 patients (207 men and 157 women) with colorectal cancer. Their mean (+/-SD) ages were 64.3 +/- 12.4 and 63.8 +/- 13.3 years. A hemoglobin level of less than 10 g/dl was the criterion for anemia, and 20.8% of the men and 25.8% of the women met this criterion. Univariate analysis showed that carcinoma of the cecum, ascending colon, and transverse colon; large-size carcinoma, invasion beyond the proper muscle layer; positive lymph node metastasis: and clinical stage (Dukes' B, C, and D) were factors associated with high incidence of anemia. Histological type did not affect the hematological findings. Multivariate analysis showed that age, tumor site, and tumor size were significant factors related to anemia. Depth of invasion, the presence or absence of lymph node metastasis, and Dukes' classification were not significant factors. In the presence of these factors, mean corpuscular volume and mean corpuscular hemoglobin concentration values were low, and red blood cells were microcytic and hypochromic. The incidence of a low serum iron level was about twice the frequency of a hemoglobin level of less than 10 g/dl. The results of the multivariate analysis showed that none of the factors were significantly related to iron deficiency.

Serum Ferritin in Colorectal Cancer Patients and its Prognostic Evaluation

“…This result is partially consistent with the literature (3,12) and has been observed in a significant manner in patients with a history of proctorrhagia and/or loss of more than 10% of body weight, and in cases with low HB, HT, MCV and serum iron. This finding confirms the frequent association of a history of chronic colorectal bleeding, low ferritin levels and microcytic and iron deficiency anemia (12,26,28,29). In particular, over a quarter (28.5%) of our patients with right colon cancer had low ferritin values compared to patients with left colon (8.8%) or rectal (12.8%) cancers.…”

“…Over 40% of our patients had a hemoglobin level lower than the normal laboratory range (9.5% of patients had a HB value ≤10 g/dL), showing a rather high incidence of mild anemia in colorectal cancer patients, but only 32.5% of these patients had low serum ferritin values. Anemia at the time of diagnosis of colorectal cancer is reported in about 25-45% of cases, depending on the HB value selected as the criterion for anemia (28,29). This anemia has been associated with iron deficiency (12,28,29) but low-grade anemia may also be related to impaired iron utilization (2,4,12,15).…”

“…Anemia at the time of diagnosis of colorectal cancer is reported in about 25-45% of cases, depending on the HB value selected as the criterion for anemia (28,29). This anemia has been associated with iron deficiency (12,28,29) but low-grade anemia may also be related to impaired iron utilization (2,4,12,15). A significant relationship between HB values of less than 10 g/dL and the age of patients and the size and site of tumors in colorectal cancer has been reported in a multivariate analysis (29).…”

“…This anemia has been associated with iron deficiency (12,28,29) but low-grade anemia may also be related to impaired iron utilization (2,4,12,15). A significant relationship between HB values of less than 10 g/dL and the age of patients and the size and site of tumors in colorectal cancer has been reported in a multivariate analysis (29). Patients with right-sided cancers have been shown to have a higher incidence of iron deficiency and anemia than patients with left-sided and rectal tumors (12).…”

“…Patients with right-sided cancers have been shown to have a higher incidence of iron deficiency and anemia than patients with left-sided and rectal tumors (12). A relationship between anemia and Dukes' stage of colorectal cancer has not been evident in the majority of studies (12,15,29).…”