AGA Clinical Practice Guidelines on the Gastrointestinal Evaluation of Iron Deficiency Anemia

Hew, Simon; Goss, Kathryn

doi:10.1053/j.gastro.2020.10.064

Cited by 2 publications

(6 citation statements)

References 3 publications

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“…We also found that symptoms were a more efficient indication for endoscopy than ID, as ID in the absence of symptoms did not increase the risk of cancer in women with anaemia. Finally, a subsequent published correspondence with the authors of the guideline noted that the AGA guideline did not address ID without anaemia in large part due to a ‘paucity of data’ 12 19. Our findings help address this deficit.…”

Section: Discussionmentioning

confidence: 73%

“…Finally, a subsequent published correspondence with the authors of the guideline noted that the AGA guideline did not address ID without anaemia in large part due to a ‘paucity of data’. 12 19 Our findings help address this deficit. Whether (fecal immunochemical test (FIT)) testing can be used to further stratify who in this age group should undergo endoscopy, as has been shown to be the case in older age groups, can be tested in future studies.…”

Section: Discussionmentioning

confidence: 77%

“…In those without available ferritins, we used total iron binding capacity greater than upper limits of normal (428 µg/dL), which has a higher correlation with ferritin than does iron saturation. 12 13 Anaemia was defined as the LLN in our laboratories, haemoglobin <11.5 g/dL or haematocrit <34%, obtained during the year prior to the study entry date. When multiple tests were found, the test closest to the index date was used.…”

Section: Methodsmentioning

confidence: 99%

“…ID was defined as ferritin less than the lower limits of normal (LLN; 10–22 µg/L during this period). In those without available ferritins, we used total iron binding capacity greater than upper limits of normal (428 µg/dL), which has a higher correlation with ferritin than does iron saturation 12 13…”

Section: Methodsmentioning

confidence: 99%

“…A recent Veterans Administration study was large and population based but did not examine the role of symptoms 11. Data are even more scarce in those with iron deficiency (ID) without anaemia 12. In order to examine the inter-relation of ID, anaemia and symptoms on the incidence of major GI cancers in women of menstruating age, we undertook a retrospective cohort study.…”

Section: Introductionmentioning

confidence: 99%

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Iron deficiency and symptoms in women aged 20–49 years and relation to upper gastrointestinal and colon cancers

Szpakowski

Tucker

2022

BMJ Open Gastroenterol

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ObjectiveIron deficiency anaemia (IDA) in women aged 20–49 years may be caused by menses or gastrointestinal cancer. Data are sparse on the yield of endoscopy/colonoscopy in this population. Our aim was to determine the association of IDA and symptoms with cancers.DesignRetrospective cohort study within Kaiser Permanente Northern California. Participants were women aged 20–49 years tested for iron stores and anaemia during 1998, 2004 and 2010 and followed for 5 years for outcomes of oesophageal, gastric and colon cancers. Symptoms from the three prior years were grouped into dysphagia, upper gastrointestinal (UGI), lower gastrointestinal (LGI), rectal bleeding and weight loss.ResultsAmong 9783 anaemic women aged 20–49 years, there were no oesophageal, 6 gastric and 26 colon cancers. Incidences per 1000 for gastric cancer with and without iron deficiency (ID) were 0.60 (95% CI 0.23 to 1.55) and 0.63 (95% CI 0.17 to 2.31), and for colon cancer, 2.72 (95% CI 1.72 to 4.29) and 2.53 (95% CI 1.29 to 4.99). Endoscopies for UGI or dysphagia symptoms rather than bidirectional endoscopy for ID yielded more gastric cancers (n=5 and n=4, respectively) with fewer procedures (3793 instead of 6627). Colonoscopies for LGI or rectal bleed instead of for ID would detect more colon cancers (n=19 and n=18) with about 40% of the procedures (=2793/6627).ConclusionsUGI and colon cancers were rare in women of menstruating age and when controlled for anaemia were as common without as with ID. Using symptoms rather than IDA as an indication for endoscopy found equal numbers of cancers with fewer procedures.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 77%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Iron deficiency and symptoms in women aged 20–49 years and relation to upper gastrointestinal and colon cancers

Szpakowski

Tucker

2022

BMJ Open Gastroenterol

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Critical Analysis of the Applicability of Small Bowel Capsule Endoscopy Performance Measures among 2 Portuguese Centers with Different Capsule Endoscopy Platforms

Gomes¹,

O'Neill²,

Pinho³

et al. 2022

GE Port J Gastroenterol

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Introduction: The European Society of Gastrointestinal Endoscopy (ESGE) identified the need to benchmark the quality of small bowel capsule endoscopy (SBCE) and produced a set of performance measures (PM). The aim of this study is to critically evaluate the accordance of the PM for SBCE in two Portuguese centers with different SBCE platforms. Methods: The authors conducted a cross-sectional analysis of consecutive SBCE performed in an 18-month period in 2 Portuguese centers that used two different SBCE platforms Mirocam® (IntroMedic, Seoul, South Korea) and PillCam® (Medtronic, Yokneam, Israel). A total of 10 PM (6 key, 4 minor) were evaluated and compared between the 2 centers. Results: A total of 493 SBCE were included. The minimum standard established by ESGE was reached in 3/6 key PM (complete visualization, lesion detection rate, and capsule retention rate), and none of the 4 minor PM. PM compliance significantly differed between the 2 centers: complete small bowel visualization 95.9 and 90% (p = 0.01), diagnostic yield 50.6 and 63% (p = 0.005), adequate small bowel cleansing level according to Brotz scale 69.54 and 84.6% (p ≤ 0.001), patients with high risk of capsule retention offered a patency capsule 4.2 and 73% (p ≤ 0.001), respectively. Conclusion: This study highlights and critically discusses technical and organizational issues that should be considered in defining more realistic PM thresholds, aiming to improve SBCE quality.

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AGA Clinical Practice Guidelines on the Gastrointestinal Evaluation of Iron Deficiency Anemia

Cited by 2 publications

References 3 publications

Iron deficiency and symptoms in women aged 20–49 years and relation to upper gastrointestinal and colon cancers

Iron deficiency and symptoms in women aged 20–49 years and relation to upper gastrointestinal and colon cancers

Critical Analysis of the Applicability of Small Bowel Capsule Endoscopy Performance Measures among 2 Portuguese Centers with Different Capsule Endoscopy Platforms

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