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Korean J Med > Volume 87(1); 2014 > Article
The Korean Journal of Medicine 2014;87(1): 53-60.
외래에서 철 결핍 빈혈로 진단된 남자 환자의 악성 종양 유병률과 연관인자
이병현1, 이재중1, 심재겸1, 김정선1, 김대식1, 박세종2, 이세련1, 박 용1, 최철원1, 김병수1
1고려대학교 의과대학 내과학교실
2G샘통합암병원 혈액종양내과
Prevalence of and Factors Associated with Malignancy in Males with Iron-Deficiency Anemia
Byung Hyun Lee1, Jae Joong Lee1, Jae Kyeom Sim1, Jung Sun Kim1, Dae Sik Kim1, Seh Jong Park2, Se Ryeon Lee1, Yong Park1, Chul Won Choi1, Byung Soo Kim1
1Department of Internal Medicine, Korea University Medical Center, Seoul
2Department of Hemato-oncology, G SAM Integrative Cancer Hospital, Gunpo, Korea
Corresponding Author: Chul Won Choi ,
Received: September 9, 2013;   Revised: October 18, 2013;   Accepted: October 31, 2013.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background/Aims: Despite several reports on clinical aspects of anemia and malignancy, little is known of male patients with iron-deficiency anemia (IDA) and malignancy in Korea. We examined the cause of anemia, prevalence of and factors associated with malignancy, and treatment response to iron therapy in male IDA patients.
Methods:
The results of 202 males with IDA seen from March 2008 to June 2013 were analyzed retrospectively. The patients were divided into two groups based on the causes of anemia: the cancer group included patients with anemia caused by malignancy and the non-cancer group included patients with anemia due to other causes. We compared the clinical characteristics and response to iron therapy between the two groups.
Results:
The most common cause of IDA was bleeding (42.6%). The prevalence of malignancy was 11.9%, with colorectal cancer (58.3%) being the most common. Among the cancer patients (n = 24), 22 patients (91.7%) were age 50 or older. Independent factors associated with malignancy were old age (OR, 1.05; p = 0.026) and a positive stool occult blood test (OR, 7.48; p = 0.001). The treatment response to iron therapy based on a normalized hemoglobin level was lower in the cancer group (OR, 0.49; p = 0.31), but the difference did not reach statistical significance. The treatment response based on the mean hemoglobin level was significantly lower in the cancer group (12.6 ± 2.2 vs. 13.8 ± 1.6 g/dL, p = 0.016).
Conclusions:
Old age and a positive stool occult blood test were independent risk factors for malignancy in male IDA patients. We recommend screening for malignancy in patients older than 50 years or with a positive stool occult blood test.
Keywords: Anemia, Iron-Deficiency; Male; Neoplasms; Prevalence
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