PURPOSE: We investigated whether iron deficiency, with or without anemia, is associated with an increased likelihood of gastrointestinal malignancy. SUBJECTS AND METHODS: Data were obtained from the first National Health and Nutrition Examination Survey and Epidemiologic Followup Study, a nationally representative, prospective cohort study that measured hemoglobin levels and iron saturation and recorded follow-up diagnoses. We included persons 25 to 74 years of age with no previous gastrointestinal malignancy. Anemia was defined as a hemoglobin value below the fifth percentile for each age group and sex. Iron deficiency was defined as an iron saturation below 15%. RESULTS: Eighteen (0.2%) gastrointestinal malignancies were identified among the 9024 participants during the first 2 years of follow-up. None of the 442 premenopausal women with iron deficiency (92 with anemia and 350 without anemia) were diagnosed with gastrointestinal malignancy. Among men and postmenopausal women, the proportion diagnosed with gastrointestinal malignancy was 31 times greater (95% confidence interval [CI]: 9 to 107) in those with iron deficiency anemia (3/51 [6%]) and five times greater (95% CI: 1 to 21) in those with iron deficiency without anemia (2/223 [1%]), compared with those with normal hemoglobin levels and iron saturation (11/5733 [0.2%]). CONCLUSIONS: Gastrointestinal malignancy is uncommon in iron-deficient premenopausal women with or without anemia. Among men and postmenopausal women, gastrointestinal malignancy is significantly more common in those with iron deficiency than in persons with normal serum iron saturation and hemoglobin levels.
PURPOSE: We investigated whether iron deficiency, with or without anemia, is associated with an increased likelihood of gastrointestinal malignancy. SUBJECTS AND METHODS: Data were obtained from the first National Health and Nutrition Examination Survey and Epidemiologic Followup Study, a nationally representative, prospective cohort study that measured hemoglobin levels and iron saturation and recorded follow-up diagnoses. We included persons 25 to 74 years of age with no previous gastrointestinal malignancy. Anemia was defined as a hemoglobin value below the fifth percentile for each age group and sex. Iron deficiency was defined as an iron saturation below 15%. RESULTS: Eighteen (0.2%) gastrointestinal malignancies were identified among the 9024 participants during the first 2 years of follow-up. None of the 442 premenopausal women with iron deficiency (92 with anemia and 350 without anemia) were diagnosed with gastrointestinal malignancy. Among men and postmenopausal women, the proportion diagnosed with gastrointestinal malignancy was 31 times greater (95% confidence interval [CI]: 9 to 107) in those with iron deficiency anemia (3/51 [6%]) and five times greater (95% CI: 1 to 21) in those with iron deficiency without anemia (2/223 [1%]), compared with those with normal hemoglobin levels and iron saturation (11/5733 [0.2%]). CONCLUSIONS:Gastrointestinal malignancy is uncommon in iron-deficient premenopausal women with or without anemia. Among men and postmenopausal women, gastrointestinal malignancy is significantly more common in those with iron deficiency than in persons with normal serum iron saturation and hemoglobin levels.
Authors: Majid Almadi; Peter M Ghali; Andre Constantin; Jacques Galipeau; Andrew Szilagyi Journal: Can J Gastroenterol Date: 2009-09 Impact factor: 3.522
Authors: Rami Abbass; Marc Hopkins; D Robert Dufour; Jason Schallheim; Oliver J Szeto; Louis Y Korman; Richard L Amdur; Timothy O Lipman Journal: Dig Dis Sci Date: 2011-01-11 Impact factor: 3.199
Authors: Jennifer M Noto; Jennifer A Gaddy; Josephine Y Lee; M Blanca Piazuelo; David B Friedman; Daniel C Colvin; Judith Romero-Gallo; Giovanni Suarez; John Loh; James C Slaughter; Shumin Tan; Douglas R Morgan; Keith T Wilson; Luis E Bravo; Pelayo Correa; Timothy L Cover; Manuel R Amieva; Richard M Peek Journal: J Clin Invest Date: 2012-12-21 Impact factor: 14.808