EP.WE.548The prevalence iron deficiency anaemia in patients with oesophago-gastric cancer

Abstract

Aims Blood loss from the gastrointestinal tract is the most common cause of iron deficiency anaemia (IDA) in adult men and post-menopausal women. Up to 10% of patients with IDA have underlying gastrointestinal cancer. The aim of this study was to investigate prevalence of IDA in patients with oesophago-gastric cancer. Methods A retrospective cohort study of all newly diagnosed oesophago-gastric cancers (adenocarcinoma and squamous cell carcinoma) and high grade dysplasia discussed at tertiary multi-disciplinary team meeting between October 2019 and September 2020. Electronic case notes and blood profile at presentation, including ferritin and serum iron level, were analysed. Patients who did not have blood profile within three months of presentation were excluded. Results A total of 349 patients were identified, 12 were excluded due to missing data. 226 (67.1%) were male and the mean age was 69.7 ± 11.7 years. 260 (77.2%) were referred from primary care. After initial investigations, 256 (76.0%) were oesophageal cancer, 248 (73.6%) were adenocarcinoma, and 134 (39.8%) were metastatic at presentation. 128 (38.0%) patients were anaemic: 30 (23.4%) microcytic, 88 (68.8%) normocytic and 10 (7.8%) macrocytic. 98 (76.6%) anaemic patients had ferritin and/or iron levels checked. Analysis of these identified 63 (49.2%) patients with bloods consistent with IDA: 22 (34.9%) microcytic, 40 (63.5%) normocytic, and 1 (1.6%) macrocytic. Conclusions This study confirms that while there is high prevalence of anaemia in patients presenting with oesophagi-gastric cancer, IDA was diagnosed in only half of these. The predominant form of anaemia identified in these patients is normocytic.