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Prevalence, etiology and risk factors of anemia in patients with newly diagnosed cancer

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Abstract

Purpose

To determine the prevalence of anemia, and to evaluate the etiology and risk factors of anemia in patients with newly diagnosed cancer.

Methods

In this cross-sectional study, 310 patients with newly diagnosed cancer who were referred to a university hospital in Turkey over a 6-month period and 218 age-matched healthy individuals as controls were evaluated in terms of anemia: complete blood count (CBC), ferritin, transferrin saturation (TS%), serum iron (SI), cobalamin (B12), and folate levels. Carcinoma of the breast (21.3%), lung (12.9%), and gastrointestinal tract (GIT) (35.8%) accounted for the majority of the patients, and 44.7% of the patients had metastatic disease.

Results

Anemia was observed in 49.7% of patients with cancer and in 11.9% of healthy controls (p < 0.001). SI and TS% were lower in patients with cancer than in the controls (p < 0.001); however, the median serum ferritin level, which is also an acute-phase reactant, was higher in the patient group than the healthy matched controls (42.2 ng/mL and 41 ng/mL, respectively, p < 0.001). Folate and B12 deficiencies were seen more frequently in the cancer group than in the controls [6.5% and 0.9% (p < 0.001); 39.3% and 18.9% (p < 0.05), respectively]. In the cancer group, anemia was seen more frequently in the metastatic subgroup than in the non-metastatic subgroup (59.7% and 55.3%, respectively, p < 0.05). The prevalence of anemia was similar in both groups of patients with and without primary GIT cancers, as well as in patients who did and did not undergo tumor surgery (p > 0.05).

Conclusion

This study showed that, at the time a patient is diagnosed as having cancer, the patient already has a significant risk for anemia, nearly five times that of healthy people. Having metastatic disease, and having nutritional deficiencies as iron, B12, and folate were evaluated as possible risk factors for anemia in patients with newly diagnosed cancer, whereas cancer with GIT localization and previous history of tumor surgery were not.

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Funding

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Authors and Affiliations

  1. Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey

    Gökçe Kenar

  2. Division of Oncology, Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey

    Elif Berna Köksoy, Yüksel Ürün & Güngör Utkan

Authors
  1. Gökçe Kenar
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  2. Elif Berna Köksoy
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  3. Yüksel Ürün
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  4. Güngör Utkan
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Contributions

All the authorship contributions were declared in line with the ICMJE 4 criteria: GK wrote the paper. GK, EBK and YU collected data. GK analyzed the data. GU supervised the project.

Corresponding author

Correspondence to Gökçe Kenar.

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Conflict of interest

All the authors declare that they have no conflicts of interest.

Ethics approval

Ankara University Hospital Ethics board approved the study with the number of 20–644-12.

Informed consent

All healthy subjects gave written informed consent before participation.

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This study was presented as an abstract in the abstract session in the the American Society of Clinical Oncology (ASCO) annual meeting 2013 accessible with the link:

https://ascopubs.org/doi/abs/10.1200/jco.2013.31.15_suppl.e20655

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Kenar, G., Köksoy, E.B., Ürün, Y. et al. Prevalence, etiology and risk factors of anemia in patients with newly diagnosed cancer. Support Care Cancer 28, 5235–5242 (2020). https://doi.org/10.1007/s00520-020-05336-w

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  • DOI: https://doi.org/10.1007/s00520-020-05336-w

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