DIAGNOSTIC YIELD OF ENDOSCOPY IN ASYMPTOMATIC PATIENTS WITH NON-IRON DEFICIENCY ANAEMIA

Aims Endoscopic evaluation of the gastrointestinal (GI) tract is indicated for asymptomatic patients with iron deficiency anaemia (IDA) to rule out GI malignancy. However, there is a paucity of evidence for endoscopy in anaemic patients without iron deficiency (non-IDA). Our aim was to compare the diagnostic yield of endoscopy in asymptomatic patients with non-IDA compared to those with IDA.

Methods We retrospectively collected data of 847 consecutive patients referred for endoscopy with anaemia between January and December 2019 at a district general hospital. Demographics, endoscopy reports and laboratory tests were reviewed. Patients with gastrointestinal symptoms or incomplete data were excluded.

Results A total of 527 patients were included, 415 had evidence of IDA and 112 had non-IDA. Patients with IDA were younger (median age 72 vs. 76 years, p=0.005) and more likely to be female (72% vs. 59%, p=0.01). Both groups had similar median serum haemoglobin (109 vs. 108, p=0.22). Gastritis (35.2%) and oesophagitis (25.7%) were the most common endoscopic diagnoses in both groups. Upper GI cancers were found in 0.7% (3/415) of patients with IDA compared with 1.7% (2/112) of patients with non-IDA (p=0.28). Colorectal cancers were found in 3.3% (9/269) of patients with IDA compared with 1.5% (1/65) of patients with non-IDA (p=0.69). In multivariate analysis, age (OR 0.94, 95% CI 0.89-0.98, p=0.01) and haemoglobin (OR 1.03, 95% CI 1.01-1.05, p=0.004) were associated with malignancy.

Conclusions The diagnostic yield of endoscopy in asymptomatic patients with non-IDA is similar to those with iron deficiency anaemia. Prospective studies are required to confirm our findings.

Publication History

Article published online:
14 April 2022