Endoscopic and Colonoscopic Findings in Patients with Iron Deficiency Anemia: The Risk of Cancer

Anemia is a key indicator of malignancy risk and iron deficiency anemia (IDA) is the most considerable contributor, accounting for 50% of all causes of anemia. The present study aimed at evaluating the endoscopic and colonoscopic findings in patients with IDA without gastrointestinal (GI) symptoms.
One-hundred and eighteen patients with IDA were selected for this cross sectional study. IDA was defined according to the world health organization criteria. All patients were assessed by endoscopy and colonoscopy.
Out of 118 patients with IDA without GI symptoms, 84 patients (71.2%) were older than 50 years and 40 patients (33.9%) were male. According to colonoscopy reports, colon cancer was prominent finding in 10.2% of patients and based on Endoscopic findings, gastritis (16.9%). Of 20 gastritis patients, 19 patients were tested for Helicobacter pylori (H. pylori) that was positive in 13 patients (68.4%). Out of 12 patients with colon cancer, 8 patients (66.7%) were males and 4 (33.3%) of them were females (P = 0.030) that the most common cancers were right-side colons and well differentiated adenocarcinoma.
Colon cancer in male patients with IDA has significant risk and asymptomatic patients with IDA have an increased risk of gastric and colorectal neoplasia and should undergo examination of the upper and lower GI tract. Also, gastritis with H. pylori can positively associate with colon and gastric cancers in patients with IDA. Further studies are necessary to assess the association between IDA and risk of malignancy.