The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Should asymptomatic young men with iron deficiency anemia necessarily undergo endoscopy?

  • Kim, Nam Hee (Preventive Healthcare Center, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Jung Ho (Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Dong Il (Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Sohn, Chong Il (Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Choi, Kyuyong (Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Jung, Yoon Suk (Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • Received : 2016.12.17
  • Accepted : 2017.04.03
  • Published : 2018.11.01
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Abstract

Background/Aims: There has been no evidence for the necessity of endoscopy in asymptomatic young men with iron deficiency anemia (IDA). To determine whether endoscopy should be recommended in asymptomatic young men with IDA, we compared the prevalence of gastrointestinal (GI) lesions between young men (< 50 years) with IDA and those without IDA. Methods: We conducted a case-control study on asymptomatic young men aged < 50 years who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health checkup between 2010 and 2014. Results: Of 77,864 participants, 128 (0.16%) had IDA and 512 subjects without IDA were matched for several variables including age. Young men with IDA had a significantly higher proportion of colorectal cancer (CRC) (0.8% vs. 0.0%, p = 0.045), villous adenoma (0.8% vs. 0.0%, p = 0.045), and inflammatory bowel disease (IBD; 2.3% vs. 0.4%, p = 0.025) than those without IDA. Additionally, the prevalence of advanced colorectal neoplasia (ACRN) tended to be higher in subjects with IDA than in those without IDA (3.1% vs. 1.0%, p = 0.084). The prevalence of significant lower GI lesions including ACRN and IBD was higher in subjects with IDA than in those without IDA (5.5% vs. 1.4%, p = 0.011). Regarding upper GI lesions, a positive association with IDA was observed only for gastric ulcer (4.7% vs. 1.0%, p = 0.011). Conclusions: GI lesions including CRC, villous adenoma, IBD, and gastric ulcer were more common in asymptomatic young men with IDA. Our results suggest that EGD and particularly colonoscopy should be recommended even in asymptomatic young men with IDA.

Keywords

References

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