A220 TIME TO DIAGNOSIS OF COLORECTAL CANCER FROM FINDING OF IRON DEFICIENCY ANEMIA

• Published in: Journal of the Canadian Association of Gastroenterology
• Main Authors: Zhou, N, Costello, J
• Format: Text
• Language: English
• Published: Oxford University Press 2018
• Subjects: Paper Sessions; Canada; Ida; Newfoundland
• Online Access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6508408/; https://doi.org/10.1093/jcag/gwy009.220

BACKGROUND: Colorectal cancer (CRC) is the 3(rd) most commonly diagnosed cancer within Canada. Newfoundland has the highest CRC incidence rates per capita and mortality rates in the country. There have been several well documented signs and symptoms of CRC, including microcytic anemia/iron deficiency anemia (IDA). Current practice is to have those with IDA be considered for upper or lower GI investigations. Delays in referral for appropriate investigations can lead to a delay in diagnosis. It has been demonstrated that early detection of CRC can improve survival. Referral to those who are able to perform endoscopy of the GI tract or other methods of accessing the GI tract can decrease the amount of time from documentation of IDA to diagnosis of CRC. The cornerstone of CRC treatment remains early diagnosis and early treatment. AIMS: Determine the amount of time between documentation of either iron deficiency anemia, microcytosis, or hypoferritinemia and subsequent diagnosis of colorectal cancer METHODS: This is a retrospective study on all patients in Newfoundland with a new diagnosis of colorectal cancer in the year 2009. Records were obtained from the Dr. H Bliss Murphy Cancer Care center. A chart review was completed to determine how many patients had either pre-existing iron deficiency anemia (IDA) - defined as a hemoglobin below 120 g/L for women, or a hemoglobin below 140 g/L for men; a microcytosis – defined as an MCV below 80 μm(3); or a ferritin below 50 ng/ml. Time from laboratory finding to diagnosis was calculated. The date of diagnosis was determined by the date of submission of the pathology sample confirming histologic evidence of colorectal cancer. RESULTS: 500 patients were diagnosed with colorectal cancer in 2009 in Newfoundland. Of the 500 patients, we were able to obtain laboratory data prior to the diagnosis of CRC on 1 or more of our parameters on 213 patients. Of the 213 patients 120 had anemia, 46 had microcytosis and 72 had hypoferritinemia prior to their diagnosis of colorectal cancer. ...