외래에서 철 결핍 빈혈로 진단된 남자 환자의 악성 종양 유병률과 연관인자

Abstract

Background/Aims: Despite several reports on clinical aspects of anemia and malignancy, little is known of male patients withiron-deficiency anemia (IDA) and malignancy in Korea. We examined the cause of anemia, prevalence of and factors associatedwith 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 weredivided into two groups based on the causes of anemia: the cancer group included patients with anemia caused by malignancy andthe non-cancer group included patients with anemia due to other causes. We compared the clinical characteristics and response toiron 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 factorsassociated with malignancy were old age (OR, 1.05; p = 0.026) and a positive stool occult blood test (OR, 7.48; p = 0.001). Thetreatment response to iron therapy based on a normalized hemoglobin level was lower in the cancer group (OR, 0.49; p = 0.31), butthe difference did not reach statistical significance. The treatment response based on the mean hemoglobin level was significantlylower 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. Werecommend screening for malignancy in patients older than 50 years or with a positive stool occult blood test.