Retrospective analysis of gastroscopy and colonoscopy results of patients admitted to the internal medicine service for malignancy investigation with the diagnosis of iron deficiency anemia

Introduction and Aim: Iron deficiency anemia is a primary concern for internal medicine physicians because it can be the first sign of serious conditions such as malignancy and because of its common gastrointestinal etiology. The aim of the study is to retrospectively examine the esophagogastroduodenoscopy (EGD) and colonoscopy results of patients admitted to the internal medicine department for malignancy investigation with the diagnosis of iron deficiency anemia.. Materials and Methods: A retrospective analysis was conducted on 210 patients admitted to the Internal Medicine Clinic of the Adıyaman Training and Research Hospital of the Turkish Ministry of Health between January 1, 2022, and August 30, 2024, for iron deficiency anemia. Categorical variables were presented as frequency (n) and percentage (%). Laboratory parameters were compared using the Mann-Whitney U Test, Fisher's Exact Test, and Pearson Chi-Square test based on various clinical and patient characteristics. ROC Analysis was performed to determine the variables predicting EGD and colonoscopy findings (present-absent). Multivariate Logistic Regression Analysis was conducted to determine the factors affecting EGD and colonoscopy findings. Results: Of the patients, 124 (59.05%) were female and 86 (40.95%) were male. EGD could not be performed in 15 of 210 patients (7.10%) due to various reasons. Malignant masses were detected in 14 of 195 patients (7.18%) who underwent EGD. Histopathological diagnoses of patients with malignant masses were as follows; gastric cancer in 10 patients (71.43%), esophageal cancer in 1 patient (7.14%), and ampulla of Vater cancer in 3 patients (21.43%). Other pathological findings in patients who underwent EGD were; The following were detected: gastritis in 133 patients (68.21%), peptic ulcer in 15 patients (7.69%), polyp in 13 patients (6.67%), esophagitis in 5 patients (2.56%), esophageal varices in 2 patients (1.03%), hiatal hernia in 7 patients (3.59%), bulbit in 9 patients (4.62%), angiodysplasia in 2 patients (1.03%) and phlebectasia in 1 patient (0.51%). Colonoscopy could not be performed in 49 of 210 patients (23.39%) due to various reasons. Malignant masses were detected in 11 of 161 patients (6.83%) who underwent colonoscopy. Histopathological diagnoses of patients with malignant masses were detected as colon cancer in 10 patients (90.91%) and metastatic mass of unknown primary in 1 patient (9.09%). Further examination revealed that the patient had endometrial cancer. Other pathological findings in patients undergoing colonoscopy included angiodysplasia in 2 patients (1.24%), diverticulosis coli in 5 patients (3.11%), external hemorrhoids in 8 patients (4.97%), internal hemorrhoids in 31 patients (19.25%), infectious colitis in 3 patients (1.86%), polyps in 32 patients (19.88%), and ulcerative colitis in 4 patients (2.48%). Conclusion: We detected malignancy in 25 of the 210 patients included in the study (11.90%). Based on these results, early diagnosis of malignancies, which are detected at high rates in patients with iron deficiency anemia, is crucial. The accuracy of colonoscopies performed for screening purposes in our country for individuals over the age of 65 is well understood. In high-risk groups, timely upper GI examinations are essential. Keywords: Anemia, Iron Deficiency Anemia, Gastrointestinal, Colonoscopy, Gastroscopy, Endoscopy.