Screening for gastrointestinal malignancy in patients with iron deficiency anemia by general practitioners: An observational study

被引:17
作者
Droogendijk, Jolanda [1 ]
Beukers, Ruud [2 ]
Berendes, Paul B. [3 ]
Tax, Martine G. H. M. [3 ]
Sonneveld, Pieter [1 ]
Levin, Mark-David [4 ]
机构
[1] Erasmus MC, Dept Hematol, Rotterdam, Netherlands
[2] Albert Schweitzer Hosp, Dept Gastroenterol, Dordrecht, Netherlands
[3] Albert Schweitzer Hosp, Dept Clin Chem, Dordrecht, Netherlands
[4] Albert Schweitzer Hosp, Dept Internal Med, Dordrecht, Netherlands
关键词
Gastrointestinal malignancy; general practitioner; iron deficiency anemia; MANAGEMENT; SYMPTOMS; TRACT;
D O I
10.3109/00365521.2011.594082
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background. The prevalence of iron deficiency anemia (IDA) is 2-5% in men and postmenopausal women in the developed world. IDA is commonly caused by chronic gastrointestinal blood loss, and a thorough examination of the gastrointestinal tract must be standard practice. Objective. To retrospectively study endoscopic evaluations of patients from general practitioners diagnosed with IDA in a peripheral hospital laboratory in order to determine the cause of IDA and the number of gastrointestinal malignancies. Material and methods. We retrospectively evaluated all patients with IDA diagnosed in a peripheral hospital laboratory by the general practitioner in the region of our hospital from 1 January 2004 until 31 December 2005. We included women older than 50 and men 18 years and older without a history of IDA in the previous 2 years. Results. In 2 years, 287 patients were newly diagnosed with IDA in our hospital laboratory. Only 90 (31%) patients were endoscopically evaluated within 4 months. Gastrointestinal endoscopy revealed at least one lesion potentially responsible for blood loss in 41 of 90 (46%) patients. The most common lesions identified by gastroduodenal endoscopy were erosive esophagitis, gastritis and duodenitis (14%). Cancer was the most commonly detected lesion in the colon, accounting for 17 of 21 colonic lesions explaining IDA. In total, gastrointestinal malignancy was diagnosed in 2% of screened patients. Factors determining the decision for endoscopic screening were lower hemoglobin level, lower ferritin level and male gender. Conclusion. In our retrospective study of patients with IDA, only 31% received any form of endoscopic evaluation. In general practice, IDA is investigated suboptimally, and interventions other than the issuing of guidelines are needed to change practice.
引用
收藏
页码:1105 / 1110
页数:6
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