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Frequency of colorectal cancer in patients with iron deficiency anaemia
Correspondence
to the Editor
Frequency anaemia
of colorectal
cancer
Sir Chronic occult bleeding from the gastrointestinal tract may present as a positive result on a faecal occult blood test, or as iron deficiency anaemia with or without a positive faecal occult blood test. The aim of this study was to attempt to establish a relationship between iron deficiency anaemia and the results of an immunochemical faecal occult blood test, and to clarify the association between asymptomatic patients with iron deficiency anaemia and colorectal cancer. In a population based cross sectional study, 44496 asymptomatic subjects (Table I) underwent an immunochemical faecal occult blood test. Subjects were divided into two groups, according to a laboratory finding of iron deficiency anaemia, and the positivity rate of an immunochemical occult blood test and the predictive value for colorectal cancer were compared in the groups positive or negative for iron deficiency anaemia. The faecal occult blood test was positive in 9.4% of subjects with iron deficiency anaemia and in 5.9% of subjects without whilst the predictive value was 7.1% and 2.9%, respectively, in subjects with and without iron deficiency anaemia a significant difference being observed in the positivity rate (p
sex
88
10,371 7,056 17,427
IyMrdFwlla 16,985 10,084 27,069
with iron deficiency
bLk Il. Comparison of po&ivity rate and predictive value in subjects with and without iron deftciency anaemia in an immuncchemical faecat occult b&d screening for colorectal cancer.
Totalno. of cases No. positiveoccult blood cases Positivityrate WI1 No. casesof colorectatcancerdetected Predictivevaluefor cotorectstcancer W/W’
1957 184 9.4% 13 7.1%
42539 2518 5.9% 73 2.9%
44496 2702 6.1% 86 3.2%
‘pd. 001 far diffe~ooe in po&ivkyrateof f8acal occult blood tast baWen sub&&s with and without imn defkienoy an6emia; ‘*p&o5 for differano& in predictive vafus of f&a! oocuft blood test far wlorectal cbncer betw@en subjects with and wkhiwt imn deficiencyanaemia.
munochemical test, and between asymptomatic patients with iron deficiency anaemia and colorectal cancer. Accordingly, asymptomatic iron deficiency anaemia patients with positive immunochemical occult blood should be considered as priority candidates for the examination of colon and rectum.
H. Nakama, B. Zhang, N. Kamijo’, A.S.M.A. Fattah
Meb 55-64 65-74 Total
in patients
0.6 0.7 0.6
Department of Public Health, Shinshu University School of Medicine, Matsumoto; I Department Internal Medicine, Hata Central Hospital, Japan. Fax: +8 1-263 13414269. Study supported in part by Grants-in-Aid for Scientific Research INo. 096703841 Tom Ministry of Education, Science and Culture of Japan and Cancer Research (No. 8-21 from Ministry of Health and Welfare of Japan.
to the Editor
Frequency anaemia
of colorectal
cancer
Sir Chronic occult bleeding from the gastrointestinal tract may present as a positive result on a faecal occult blood test, or as iron deficiency anaemia with or without a positive faecal occult blood test. The aim of this study was to attempt to establish a relationship between iron deficiency anaemia and the results of an immunochemical faecal occult blood test, and to clarify the association between asymptomatic patients with iron deficiency anaemia and colorectal cancer. In a population based cross sectional study, 44496 asymptomatic subjects (Table I) underwent an immunochemical faecal occult blood test. Subjects were divided into two groups, according to a laboratory finding of iron deficiency anaemia, and the positivity rate of an immunochemical occult blood test and the predictive value for colorectal cancer were compared in the groups positive or negative for iron deficiency anaemia. The faecal occult blood test was positive in 9.4% of subjects with iron deficiency anaemia and in 5.9% of subjects without whilst the predictive value was 7.1% and 2.9%, respectively, in subjects with and without iron deficiency anaemia a significant difference being observed in the positivity rate (p
sex
88
10,371 7,056 17,427
IyMrdFwlla 16,985 10,084 27,069
with iron deficiency
bLk Il. Comparison of po&ivity rate and predictive value in subjects with and without iron deftciency anaemia in an immuncchemical faecat occult b&d screening for colorectal cancer.
Totalno. of cases No. positiveoccult blood cases Positivityrate WI1 No. casesof colorectatcancerdetected Predictivevaluefor cotorectstcancer W/W’
1957 184 9.4% 13 7.1%
42539 2518 5.9% 73 2.9%
44496 2702 6.1% 86 3.2%
‘pd. 001 far diffe~ooe in po&ivkyrateof f8acal occult blood tast baWen sub&&s with and without imn defkienoy an6emia; ‘*p&o5 for differano& in predictive vafus of f&a! oocuft blood test far wlorectal cbncer betw@en subjects with and wkhiwt imn deficiencyanaemia.
munochemical test, and between asymptomatic patients with iron deficiency anaemia and colorectal cancer. Accordingly, asymptomatic iron deficiency anaemia patients with positive immunochemical occult blood should be considered as priority candidates for the examination of colon and rectum.
H. Nakama, B. Zhang, N. Kamijo’, A.S.M.A. Fattah
Meb 55-64 65-74 Total
in patients
0.6 0.7 0.6
Department of Public Health, Shinshu University School of Medicine, Matsumoto; I Department Internal Medicine, Hata Central Hospital, Japan. Fax: +8 1-263 13414269. Study supported in part by Grants-in-Aid for Scientific Research INo. 096703841 Tom Ministry of Education, Science and Culture of Japan and Cancer Research (No. 8-21 from Ministry of Health and Welfare of Japan.