Iron Surveillance and Management in Gastro-Intestinal Oncology Patients: A National Physician Survey
Purpose: Iron deficiency (ID) is a complication of gastrointestinal (GI) cancers that may manifest as iron deficiency anemia (IDA). Serum ferritin monitoring and oral iron supplementation have the limitations of being falsely elevated and poorly absorbed, respectively. This study aims to assess the...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/30/11/714 |
| _version_ | 1827640172688179200 |
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| author | Emilie S. Richard Adriyan Hrycyshyn Noor Salman Alliya Remtulla Tharani Alexandria Abbruzzino Janet Smith Jacob J. Kachura Michelle Sholzberg Jeffrey D. Mosko Sami A. Chadi Ronald L. Burkes Maya Pankiw Christine Brezden-Masley |
| author_facet | Emilie S. Richard Adriyan Hrycyshyn Noor Salman Alliya Remtulla Tharani Alexandria Abbruzzino Janet Smith Jacob J. Kachura Michelle Sholzberg Jeffrey D. Mosko Sami A. Chadi Ronald L. Burkes Maya Pankiw Christine Brezden-Masley |
| author_sort | Emilie S. Richard |
| collection | DOAJ |
| description | Purpose: Iron deficiency (ID) is a complication of gastrointestinal (GI) cancers that may manifest as iron deficiency anemia (IDA). Serum ferritin monitoring and oral iron supplementation have the limitations of being falsely elevated and poorly absorbed, respectively. This study aims to assess the discordance in surveillance, treatment practices, and awareness of ID/IDA in GI cancer patients by Canadian physicians treating these patients. Methods: From February 2020 to September 2021, a 22-question electronic survey was sent to medical oncologists (MOs), surgical oncologists (SOs), and gastroenterologists (GEs). The survey collected information about four domains: physician demographics, surveillance practices, treatment practices, and awareness of ID/IDA in GI cancer patients and ASCO/ASH guidelines. Results: A total of 108 (34 MOs, 19 SOs, and 55 GEs) of the 872 (12.4%) invited physicians completed the survey. Of these, 26.5% of MOs, 36.8% of SOs, and 70.9% of GEs measured baseline iron parameters, with few continuing surveillance throughout treatment. Ferritin was widely measured by MOs (88.9%), SOs (100%), and GEs (91.4%). Iron was supplemented if ID/IDA was identified pre-treatment by 66.7% of MOs, 85.7% of SOs, and 94.2% of GEs. Parenteral iron was prescribed by SOs (100%), while oral iron was prescribed by MOs (83.3%) and GEs (87.9%). Only 18.6% of physicians were aware of the ASCO/ASH guidelines regarding erythropoiesis-stimulating agents with parenteral iron for treating chemotherapy-induced anemia. Conclusion: Results illustrate variations in practice patterns for IDA management across the different physician specialties. Moreover, there appeared to be gaps in the knowledge and care surrounding evidence-based IDA management principles which may contribute to poor clinical outcomes. |
| first_indexed | 2024-03-09T16:55:10Z |
| format | Article |
| id | doaj.art-d5c91d8ba6ad4367a95ad245b4ead749 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T16:55:10Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-d5c91d8ba6ad4367a95ad245b4ead7492023-11-24T14:37:12ZengMDPI AGCurrent Oncology1198-00521718-77292023-11-0130119836984810.3390/curroncol30110714Iron Surveillance and Management in Gastro-Intestinal Oncology Patients: A National Physician SurveyEmilie S. Richard0Adriyan Hrycyshyn1Noor Salman2Alliya Remtulla Tharani3Alexandria Abbruzzino4Janet Smith5Jacob J. Kachura6Michelle Sholzberg7Jeffrey D. Mosko8Sami A. Chadi9Ronald L. Burkes10Maya Pankiw11Christine Brezden-Masley12Department of Medicine, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, CanadaDepartment of Medicine, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, CanadaDepartment of Medicine, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, CanadaDepartment of Medicine, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, CanadaDepartment of Medicine, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, CanadaDepartment of Medicine, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, CanadaDepartment of Medicine, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, CanadaDepartment of Medicine, Division of Oncology/Hematology, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, CanadaDepartment of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 3H2, CanadaSprott Department of Surgery, Division of General Surgery, Toronto General Hospital, University Health Network, Toronto, ON M5G 2C4, CanadaDepartment of Medicine, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, CanadaDepartment of Medicine, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, CanadaDepartment of Medicine, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, CanadaPurpose: Iron deficiency (ID) is a complication of gastrointestinal (GI) cancers that may manifest as iron deficiency anemia (IDA). Serum ferritin monitoring and oral iron supplementation have the limitations of being falsely elevated and poorly absorbed, respectively. This study aims to assess the discordance in surveillance, treatment practices, and awareness of ID/IDA in GI cancer patients by Canadian physicians treating these patients. Methods: From February 2020 to September 2021, a 22-question electronic survey was sent to medical oncologists (MOs), surgical oncologists (SOs), and gastroenterologists (GEs). The survey collected information about four domains: physician demographics, surveillance practices, treatment practices, and awareness of ID/IDA in GI cancer patients and ASCO/ASH guidelines. Results: A total of 108 (34 MOs, 19 SOs, and 55 GEs) of the 872 (12.4%) invited physicians completed the survey. Of these, 26.5% of MOs, 36.8% of SOs, and 70.9% of GEs measured baseline iron parameters, with few continuing surveillance throughout treatment. Ferritin was widely measured by MOs (88.9%), SOs (100%), and GEs (91.4%). Iron was supplemented if ID/IDA was identified pre-treatment by 66.7% of MOs, 85.7% of SOs, and 94.2% of GEs. Parenteral iron was prescribed by SOs (100%), while oral iron was prescribed by MOs (83.3%) and GEs (87.9%). Only 18.6% of physicians were aware of the ASCO/ASH guidelines regarding erythropoiesis-stimulating agents with parenteral iron for treating chemotherapy-induced anemia. Conclusion: Results illustrate variations in practice patterns for IDA management across the different physician specialties. Moreover, there appeared to be gaps in the knowledge and care surrounding evidence-based IDA management principles which may contribute to poor clinical outcomes.https://www.mdpi.com/1718-7729/30/11/714iron deficiencyiron deficiency anemiaanemiagastrointestinal cancer |
| spellingShingle | Emilie S. Richard Adriyan Hrycyshyn Noor Salman Alliya Remtulla Tharani Alexandria Abbruzzino Janet Smith Jacob J. Kachura Michelle Sholzberg Jeffrey D. Mosko Sami A. Chadi Ronald L. Burkes Maya Pankiw Christine Brezden-Masley Iron Surveillance and Management in Gastro-Intestinal Oncology Patients: A National Physician Survey Current Oncology iron deficiency iron deficiency anemia anemia gastrointestinal cancer |
| title | Iron Surveillance and Management in Gastro-Intestinal Oncology Patients: A National Physician Survey |
| title_full | Iron Surveillance and Management in Gastro-Intestinal Oncology Patients: A National Physician Survey |
| title_fullStr | Iron Surveillance and Management in Gastro-Intestinal Oncology Patients: A National Physician Survey |
| title_full_unstemmed | Iron Surveillance and Management in Gastro-Intestinal Oncology Patients: A National Physician Survey |
| title_short | Iron Surveillance and Management in Gastro-Intestinal Oncology Patients: A National Physician Survey |
| title_sort | iron surveillance and management in gastro intestinal oncology patients a national physician survey |
| topic | iron deficiency iron deficiency anemia anemia gastrointestinal cancer |
| url | https://www.mdpi.com/1718-7729/30/11/714 |
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