Prevalence of gastrointestinal malignancy in iron deficiency without anaemia: A systematic review and meta-analysis

Alexandre, Leo; Manning, Charelle; Chan, Simon

doi:10.1016/j.ejim.2019.12.015

Cited by 6 publications

(6 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our group of patients age, sex and haemoglobin values were not independent risk factors for underlying ANLs as has been suggested in previous studies ( 20 ). It is important to note that in our study we included patients with iron deficiency though not anaemia.…”

Section: Discussionsupporting

confidence: 84%

The Value of Quantitative Faecal Immunochemical Testing as a Prioritisation Tool for the Endoscopic Investigation of Patients With Iron Deficiency

2021

View full text Add to dashboard Cite

Difficulty in providing endoscopy for patients with iron deficiency anaemia (IDA) during the COVID-19 pandemic has highlighted the requirement for a prioritisation tool. We aimed to test the validity of qFIT as a prioritisation tool in patients with iron deficiency and its ability to identify patients with advanced neoplastic lesions (ANLs). Data collected from patients referred with biochemically proven iron deficiency (ferritin ≤ 15 μg/L) and synchronous qFIT who underwent full gastrointestinal investigation within NHS Greater Glasgow and Clyde was analysed retrospectively. Patients who did not undergo full investigation, defined as gastroscopy and colonoscopy or CT colonography, were excluded. ANLs were defined as defined as upper GI cancer, colorectal adenoma ≥ 1 cm or colorectal cancer. Area under the curve (AUC) analysis was performed on qFIT results and outcome, defined as the presence of an ANL. AUC analysis guided cut-off scores for qFIT. Patients with a qFIT of <10, 10–200, >200, were allocated a score of 1, 2, and 3, respectively. A total of 575 patients met criteria for inclusion into the study. Overall, qFIT results strongly predicted the presence of ANLs (AUC 0.87, CI 0.81–0.92; P < 0.001). The prevalence of ANLs in patients with scores 1–3 was 1.2, 13.5, and 38.9% respectfully. When controlled for other significant variables, patients with a higher qFIT score were statistically more likely to have an ANL (qFIT score = 2; OR 12.8; P < 0.001, qFIT score = 3, OR 50.0; P < 0.001). A negative qFIT had a high NPV for the presence of ANLs (98.8%, CI 97.0–99.5%). These results strongly suggest that qFIT has validity as a prioritisation tool in patients with iron deficiency; both allowing for a more informed decision of investigation of patients with very low risk of malignancy, and in identifying higher risk patients who may benefit from more urgent endoscopy.

show abstract

Section: Discussionsupporting

confidence: 84%

The Value of Quantitative Faecal Immunochemical Testing as a Prioritisation Tool for the Endoscopic Investigation of Patients With Iron Deficiency

2021

View full text Add to dashboard Cite

show abstract

“…Since the gastrointestinal (GI) malignancy was significantly more common in anemic patients based on cohort study, multiple studies were done to see the association between anemia and GI malignancy. [ 8 ]…”

Section: Introductionmentioning

confidence: 99%

Association between anemia and gastrointestinal malignancy among male patients in a university hospital in Riyadh, Saudi Arabia

Alobidan

Amin

2021

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

Introduction: Iron deficiency was reported as the most common nutritional deficiency in developing and developed countries. Many studies reported that iron deficiency anemia (IDA) is related to the development of gastrointestinal (GI) malignancies Aim: The current study aimed at investigating the prevalence of iron deficiency anemia among Saudi patients subjected to endoscopy procedure, and to assess the association between iron deficiency anemia and GI malignancy. Method: A retrospective study was performed over 244 Saudi patients attending King Saud University Hospital (KSUH) in Riyadh, Saudi Arabia between 2015 and 2018. Data were collected from the hospital database (esihi). Patients aged 30 years or more were recruited in this study. They had to be subjected to endoscopy before the recruitment period. Complete blood count analysis was performed for the blood samples collected from the patients. Results: The findings of the study showed that the prevalence of IDA among Saudi patients was 63.5%. Gastritis (15.16%), colon carcinoma (13.11%), and polyps (12.7%) were the most reported endoscopy results among patients with IDA. In addition, it was found that there is no significant association between IDA and GI malignancy. Conclusion: The study concluded that despite the reported significant association between IDA and GI malignancy, the current study revealed that there is no significant association between IDA and GI malignancy. This might be attributed to sample-related issues, which require more extended studies investigating larger sample sizes, in addition to including ferritin level measurements for the investigated patients.

show abstract

“…■ latter contexts as well, CTPA can be deferred and pre-emptive thrombolysis initiated instead. 8,9 Alternatively, emergency pulmonary embolectomy might be deployed, as was the case in a haemodynamically compromised PE patient in whom transoesophageal echocardiography showed McConnell's sign as well as impending paradoxical embolism characterised by a thrombus straddling a patent foramen ovale. 10 ■…”

mentioning

confidence: 99%

“…Stigmata of PE, which can be identified by TTE in haemodynamic crisis include not only right ventricular dilatation but also free floating right heart thrombus and McConnell's sign. [2][3][4][5]8,9 Letters to the editor fact that mean values for MCV remained the same for both the iron deficient subgroup and the iron replete subgroup. Also among subjects who had progressed to iron deficiency, the mean value for haemoglobin (Hb) was 132.7 g/L vs 139.2 g/L in the iron replete subgroup.…”

mentioning

confidence: 99%

“…When stratified according to age, number needed to endoscope amounted to 39 in those aged ≥50 years. 8 In a separate study (a retrospective analysis not included in the previous meta-analysis), among 287 CHF patients of mean age 70 years with IDWA, 30 were diagnosed with gastrointestinal malignancies. 9 In the latter study, anaemia was defined as Hb <12 g/dL in both men and women, and iron deficiency was defined according to the criteria cited by Al-Naseem et al 3 In that study, serum ferritin <30 μg/L had a specificity of 90% for generating a positive endoscopy result but this was at the cost of poor sensitivity (13%), in other words, at the cost of rejecting many potential candidates for endoscopy simply because they had higher serum ferritin values.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The index of suspicion for iron deficiency in non-anaemic subjects

Jolobe¹

2021

Clinical Medicine

View full text Add to dashboard Cite

We have made huge progress with regards to awareness of HIV, but we must normalise testing in both primary and secondary care to decrease late and unknown HIV diagnoses. ■ latter contexts as well, CTPA can be deferred and pre-emptive thrombolysis initiated instead. 8,9 Alternatively, emergency pulmonary embolectomy might be deployed, as was the case in a haemodynamically compromised PE patient in whom transoesophageal echocardiography showed McConnell's sign as well as impending paradoxical embolism characterised by a thrombus straddling a patent foramen ovale. 10 ■

show abstract

Prevalence of gastrointestinal malignancy in iron deficiency without anaemia: A systematic review and meta-analysis

Cited by 6 publications

References 48 publications

The Value of Quantitative Faecal Immunochemical Testing as a Prioritisation Tool for the Endoscopic Investigation of Patients With Iron Deficiency

The Value of Quantitative Faecal Immunochemical Testing as a Prioritisation Tool for the Endoscopic Investigation of Patients With Iron Deficiency

Association between anemia and gastrointestinal malignancy among male patients in a university hospital in Riyadh, Saudi Arabia

The index of suspicion for iron deficiency in non-anaemic subjects

Contact Info

Product

Resources

About