Sunday, March 02, 2014

RED FLAG FRIDAY: Don't Blow Off Anemia

In a population-based study, 9 percent of adults older than 65 years with iron deficiency anemia had gastrointestinal cancer. Yikes! I know, nine percent doesn't sound like a lot. But think about how many geriatric patients we see each year with anemia! In fact, older adults with anemia had gastrointestinal cancer 31 times as often as adults without anemia. (REFERENCE: Ioannou GN. Am J Med 2002;113:276-80).

3 comments:

David Beckmann said...

So if they do a fecal immunohistochemical test or colonoscopy and all is good, we can stop the work-up? or do they also need an EGD?

David Koo said...

Great question! If I found evidence of iron deficiency anemia (ferritin < 40), I would skip any fecal guaiac testing and go straight to colonoscopy (after asking about post menopausal bleeding and checking for chronic microscopic hematuria). If the colonoscopy is negative, then I would SERIOUSLY consider an EGD. That's how my mother's gastric cancer was discovered and diagnosed early. Thanks for asking!

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