The diagnostic yield of gastroscopy in the evaluation of asymptomatic patients with iron deficiency anemia.
Endoscopy found major clinically significant lesions in 8.2% of asymptomatic iron deficiency anemia patients.
The diagnostic yield of gastroscopy in the evaluation of asymptomatic patients with iron deficiency anemia.
The diagnostic value of upper endoscopy (EGD) in asymptomatic patients with iron deficiency anemia (iron deficiency anemia) remains uncertain, given the low prevalence of upper gastrointestinal (gastrointestinal) malignancy.
We performed a retrospective cohort study comparing asymptomatic patients with laboratory-confirmed iron deficiency anemia to asymptomatic controls referred for pre-bariatric endoscopy.
endoscopy found a serious lesion in a small but real minority
Among 6,185 iron deficiency anemia patients and 2,010 controls, endoscopic pathology was significantly more frequent in the anemia group.
Diagnostic efficiency was superior in iron deficiency anemia (NNTI˜12 for clinically significant findings; <100 for malignancy) compared with controls (>30 and >1,000, respectively).
In adjusted models, iron deficiency anemia and age ≥50 years independently predicted clinically significant findings and malignancy, whereas female sex was inversely associated.
ROC analysis identified optimal age thresholds of approximately 60 years for clinically significant findings and 65 years for malignancy.
Among asymptomatic patients with iron deficiency anemia, EGD demonstrated a substantially higher yield of clinically significant findings and upper gastrointestinal malignancy than in asymptomatic controls, particularly among older individuals.
These findings provide a large real-world benchmark for the isolated diagnostic yield of EGD and may inform future risk-stratified approaches to iron deficiency anemia evaluation.