Korean J Intern Med.  2018 Nov;33(6):1084-1092. 10.3904/kjim.2016.421.

Should asymptomatic young men with iron deficiency anemia necessarily undergo endoscopy?

• Kim NH
• Park JH
• Park DI
• Sohn CI
• Choi K
• Jung YS

• KMID: 2426392
• DOI: http://doi.org/10.3904/kjim.2016.421

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.

Keyword

Iron-deficiency anemia; Men; Duodenoscopy; Colonoscopy

MeSH Terms

Adenoma, Villous
Anemia, Iron-Deficiency*
Case-Control Studies
Colonoscopy
Colorectal Neoplasms
Duodenoscopy
Endoscopy*
Endoscopy, Digestive System
Humans
Inflammatory Bowel Diseases
Iron*
Male
Prevalence
Stomach Ulcer
Iron