Background. The prevalence of iron deficiency anemia (IDA) is 25% 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.

Additional Metadata
Keywords Gastrointestinal malignancy, General practitioner, Iron deficiency anemia
Persistent URL dx.doi.org/10.3109/00365521.2011.594082, hdl.handle.net/1765/33316
Citation
Droogendijk, J, Beukers, R, Berendes, P.B, Tax, M.G.H.M, Sonneveld, P, & Levin, M.-D. (2011). Screening for gastrointestinal malignancy in patients with iron deficiency anemia by general practitioners: An observational study. Scandinavian Journal of Gastroenterology, 46(9), 1105–1110. doi:10.3109/00365521.2011.594082