A220 TIME TO DIAGNOSIS OF COLORECTAL CANCER FROM FINDING OF IRON DEFICIENCY ANEMIA

Colorectal cancer (CRC) is the 3rd most commonly diagnosed cancer within Canada. Newfoundland has the highest CRC incidence rates per capita and mortality rates in the country. There have been several well documented signs and symptoms of CRC, including microcytic anemia/iron deficiency anemia (IDA). Current practice is to have those with IDA be considered for upper or lower GI investigations. Delays in referral for appropriate investigations can lead to a delay in diagnosis. It has been demonstrated that early detection of CRC can improve survival. Referral to those who are able to perform endoscopy of the GI tract or other methods of accessing the GI tract can decrease the amount of time from documentation of IDA to diagnosis of CRC. The cornerstone of CRC treatment remains early diagnosis and early treatment. Determine the amount of time between documentation of either iron deficiency anemia, microcytosis, or hypoferritinemia and subsequent diagnosis of colorectal cancer This is a retrospective study on all patients in Newfoundland with a new diagnosis of colorectal cancer in the year 2009. Records were obtained from the Dr. H Bliss Murphy Cancer Care center. A chart review was completed to determine how many patients had either pre-existing iron deficiency anemia (IDA) - defined as a hemoglobin below 120 g/L for women, or a hemoglobin below 140 g/L for men; a microcytosis – defined as an MCV below 80 μm3; or a ferritin below 50 ng/ml. Time from laboratory finding to diagnosis was calculated. The date of diagnosis was determined by the date of submission of the pathology sample confirming histologic evidence of colorectal cancer. 500 patients were diagnosed with colorectal cancer in 2009 in Newfoundland. Of the 500 patients, we were able to obtain laboratory data prior to the diagnosis of CRC on 1 or more of our parameters on 213 patients. Of the 213 patients 120 had anemia, 46 had microcytosis and 72 had hypoferritinemia prior to their diagnosis of colorectal cancer. The median time from documentation of anemia to diagnosis of colorectal cancer was 92 days while the mean time was 377 days. The median time from documentation of microcytosis to colorectal cancer was 19 days while the mean time was 130 days. The median time from documentation of hypoferritinemia to colorectal cancer was 145.5 days while the mean time was 480 days. In 2009, the median time from documentation of IDA to CRC was longer than the recommended standard for wait times for investigation of IDA (Recommended standard wait times are within 60 days). In a province that has high rates and high mortality from CRC, our aim should be to improve timely investigation of IDA as early detection can improve outcomes None

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