Clinical risk factors for underlying gastrointestinal malignancy in iron deficiency anaemia–prospective validation of the IDIOM score
Objective: Ten percent of adults presenting with iron deficiency anaemia (IDA) have underlying cancer. This study was undertaken to prospectively validate the observation in a previous retrospective study that three simple clinical parameters can usefully predict the likelihood of gastrointestinal (...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2016-12-01
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| Series: | Cogent Medicine |
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| Online Access: | http://dx.doi.org/10.1080/2331205X.2016.1213216 |
| _version_ | 1818018071892197376 |
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| author | Clare M. Wijayasekara Susan L. Surgenor Carla A. Hatcher Andrew J. Clegg Elizabeth J. Williams Jonathon A. Snook |
| author_facet | Clare M. Wijayasekara Susan L. Surgenor Carla A. Hatcher Andrew J. Clegg Elizabeth J. Williams Jonathon A. Snook |
| author_sort | Clare M. Wijayasekara |
| collection | DOAJ |
| description | Objective: Ten percent of adults presenting with iron deficiency anaemia (IDA) have underlying cancer. This study was undertaken to prospectively validate the observation in a previous retrospective study that three simple clinical parameters can usefully predict the likelihood of gastrointestinal (GI) malignancy on investigation of patients with IDA, and to screen for other potential clinical predictors of risk. Method: Observational study of a cohort of 643 subjects attending an IDA clinic at a District General Hospital between 2012 and 2015, with multivariable analysis of the predictive value of a series of clinical variables including sex, age and haemoglobin concentration ([Hb]) for underlying GI malignancy. Results: Analysis of the validation cohort data confirmed the original observation that sex, age, and Hb were associated with the risk of GI malignancy—the parsimonious model including only these variables yielded odds ratios of 1.9 (95% confidence interval (CI): 1.1, 3.3) for males vs. females; 1.6 (95% CI: 0.9, 2.9) for age >70 vs. ≤70 years; and 2.9 (95% CI: 1.2, 6.9) for [Hb] <90.6 g/l vs. >112 g/l. Combining data from the observation and validation cohorts (total n = 1,363) identified sub-groups with cancer risks ranging from 0% to over 20%. No other predictive clinical variables were identified. Conclusions: Three simple and objective clinical parameters can be combined to provide a clinically useful cancer risk stratification model for subjects with IDA. This may assist with patient counselling and the prioritisation of investigational resources. |
| first_indexed | 2024-04-14T07:35:22Z |
| format | Article |
| id | doaj.art-eadd099421bc48be9a515cb97d113806 |
| institution | Directory Open Access Journal |
| issn | 2331-205X |
| language | English |
| last_indexed | 2024-04-14T07:35:22Z |
| publishDate | 2016-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Cogent Medicine |
| spelling | doaj.art-eadd099421bc48be9a515cb97d1138062022-12-22T02:05:42ZengTaylor & Francis GroupCogent Medicine2331-205X2016-12-013110.1080/2331205X.2016.12132161213216Clinical risk factors for underlying gastrointestinal malignancy in iron deficiency anaemia–prospective validation of the IDIOM scoreClare M. Wijayasekara0Susan L. Surgenor1Carla A. Hatcher2Andrew J. Clegg3Elizabeth J. Williams4Jonathon A. Snook5Poole Hospital NHS Foundation TrustPoole Hospital NHS Foundation TrustPoole Hospital NHS Foundation TrustUniversity of Central LancashirePoole Hospital NHS Foundation TrustPoole Hospital NHS Foundation TrustObjective: Ten percent of adults presenting with iron deficiency anaemia (IDA) have underlying cancer. This study was undertaken to prospectively validate the observation in a previous retrospective study that three simple clinical parameters can usefully predict the likelihood of gastrointestinal (GI) malignancy on investigation of patients with IDA, and to screen for other potential clinical predictors of risk. Method: Observational study of a cohort of 643 subjects attending an IDA clinic at a District General Hospital between 2012 and 2015, with multivariable analysis of the predictive value of a series of clinical variables including sex, age and haemoglobin concentration ([Hb]) for underlying GI malignancy. Results: Analysis of the validation cohort data confirmed the original observation that sex, age, and Hb were associated with the risk of GI malignancy—the parsimonious model including only these variables yielded odds ratios of 1.9 (95% confidence interval (CI): 1.1, 3.3) for males vs. females; 1.6 (95% CI: 0.9, 2.9) for age >70 vs. ≤70 years; and 2.9 (95% CI: 1.2, 6.9) for [Hb] <90.6 g/l vs. >112 g/l. Combining data from the observation and validation cohorts (total n = 1,363) identified sub-groups with cancer risks ranging from 0% to over 20%. No other predictive clinical variables were identified. Conclusions: Three simple and objective clinical parameters can be combined to provide a clinically useful cancer risk stratification model for subjects with IDA. This may assist with patient counselling and the prioritisation of investigational resources.http://dx.doi.org/10.1080/2331205X.2016.1213216gastrointestinal malignancyiron deficiency anaemia |
| spellingShingle | Clare M. Wijayasekara Susan L. Surgenor Carla A. Hatcher Andrew J. Clegg Elizabeth J. Williams Jonathon A. Snook Clinical risk factors for underlying gastrointestinal malignancy in iron deficiency anaemia–prospective validation of the IDIOM score Cogent Medicine gastrointestinal malignancy iron deficiency anaemia |
| title | Clinical risk factors for underlying gastrointestinal malignancy in iron deficiency anaemia–prospective validation of the IDIOM score |
| title_full | Clinical risk factors for underlying gastrointestinal malignancy in iron deficiency anaemia–prospective validation of the IDIOM score |
| title_fullStr | Clinical risk factors for underlying gastrointestinal malignancy in iron deficiency anaemia–prospective validation of the IDIOM score |
| title_full_unstemmed | Clinical risk factors for underlying gastrointestinal malignancy in iron deficiency anaemia–prospective validation of the IDIOM score |
| title_short | Clinical risk factors for underlying gastrointestinal malignancy in iron deficiency anaemia–prospective validation of the IDIOM score |
| title_sort | clinical risk factors for underlying gastrointestinal malignancy in iron deficiency anaemia prospective validation of the idiom score |
| topic | gastrointestinal malignancy iron deficiency anaemia |
| url | http://dx.doi.org/10.1080/2331205X.2016.1213216 |
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