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PERSPECTIVE ARTICLE

Colorectal carcinoma-induced iron deficiency anemia: A literature review and a case scenario

Ogbonna Collins Nwabuko1,2,3,4* ,  Patrick Uchenna Njoku5 ,  Ezimma Grace Obue6 ,  Alozie Uchenna Eze3 ,  Cornelius Chukwuegbo7 ,  Uche Ngozi Nwamoh8
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1 Department of Hematology and Blood Transfusion, Faculty of Basic Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria
2 Department of Public Health, Unicaf University, Lusaka, Zambia
3 Department of Hematology and Blood Transfusion, Federal Medical Centre, Umuahia, Abia State, Nigeria
4 Department of Hematology, College of Health and Medical Sciences, Gregory University, Umuahia, Abia State, Nigeria
5 Department of Family Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
6 Department of Hematology, Federal Medical Centre, Keffi, Nasarawa State, Nigeria
7 Department of Anatomical Pathology, Federal Medical Centre, Umuahia, Abia State, Nigeria
8 Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
CP 2024, 6(3), 3021
Submitted: 26 February 2024 | Accepted: 5 August 2024 | Published: 11 November 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Colorectal carcinoma (CRC) is among the leading cancers worldwide and a major cause of cancer-related mortality. Iron deficiency anemia (IDA), resulting from inadequate iron for hemoglobin production, has been increasingly linked to CRC, often leading to misdiagnosis. This study reviews the clinicopathological associations of IDA in the context of colorectal cancer, using the medical records of a septuagenarian diagnosed with both conditions as a case study. Employing the Problem-Intervention-Comparison-Outcome model, we searched for “colorectal carcinoma” and “iron deficiency anemia” as keywords. CRC ranks among the top five cancers of global health importance, with socioeconomic factors, sedentary lifestyles, and dietary choices significantly influencing both conditions. Notably, IDA is particularly associated with the right-sided CRC in individuals over 40. Upregulation of interleukin-6 in CRC cells stimulates hepcidin release, which mediates anemia of chronic disorders and IDA. The case revealed right-sided signet ring cell CRC, microcytic hypochromic anemia, bone marrow metastasis, and low serum iron and ferritin levels. This study highlights the need for increased suspicion of CRC in middle-aged and elderly patients presenting with recurrent IDA. Regular screening is essential for the early detection and improved treatment outcomes. While colonoscopy is the gold standard for prevention, its effectiveness in detecting early molecular links between neoplasia and chronic inflammation is limited. There is also no consensus on surveillance protocols, and many gastroenterologists do not adhere to recommended biopsy sampling practices. In conclusion, this study advocates for including complete blood count and iron studies as essential tests in guidelines for screening and diagnosis for CRC-related IDA to enhance diagnostic practices.

Keywords
Colorectal carcinoma
Signet ring cell carcinoma
Iron deficiency anemia
Cancer
Clinicopathological study
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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Cancer Plus, Electronic ISSN: 2661-3840 Print ISSN: 2661-3832, Published by AccScience Publishing
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