Curative resectability of gastrointestinal cancer identified from iron deficiency anemia

Abstract

The present study aimed to clarify the staging and curative resectability of gastrointestinal cancer found through iron deficiency anemia (IDA). An electronic database was used and females >51 and males >18 years old were identified who had been diagnosed with IDA at the internal medicine outpatient clinic of Asahi General Hospital (Chiba, Japan) from 1 April 2010 to 31 March 2012. IDA was defined as a hemoglobin level of <135 g/l for males and <120 g/l for females, combined with a serum ferritin level of <33.71 pmol/l. Of the 472 patients who had been diagnosed with IDA, 347 patients underwent either a gastroscopy and/or colonoscopy, including 120 patients who had undergone both gastroscopy and colonoscopy, 197 patients who only underwent gastroscopy, and 30 patients who only underwent colonoscopy. In total, 125/472 patients diagnosed with IDA did not undergo a gastroscopy or a colonoscopy. From the 50 patients who were diagnosed with cancer as a result of the investigation, 24 patients had gastric cancer and 23 patients had colorectal cancer. Of the gastric cancer patients, 6 patients were stage I, 3 patients stage II, 5 patients were stage III and 9 patients were stage IV. In colorectal cancer, 9 patients were stage II, 8 patients were stage III and 4 patients were stage IV. Curative surgery including endoscopic treatment was performed on 14 gastric cancer patients and 17 colorectal cancer patients of stage III or lower. Malignancies were found in 50 patients with IDA, and curative surgery was performed on >50% of the patients.