Antithrombotic/antiplatelet therapy and colonoscopy results in patients over 50 with iron-deficiency anemia

Introduction
This study aims to evaluate the results of asymptomatic patients who have been using anticoagulant-antiaggregant (AC-AA) agents and have had colonoscopy screening due to iron-deficiency anemia (IDA).

Material and methods
The data of 347 asymptomatic patients over the age of 50, who have received colonoscopy due to IDA, were reviewed retrospectively. The effects of sex and AC-AA administration on positive colonoscopy results, preneoplastic lesions and malignancy were investigated.

Results
Of 347 patients over 50 with IDA, 204 were female (58.8%). The mean age was 63.4 ±8.4. Positive colonoscopy results were observed more commonly in 69 male patients compared to 67 female patients (p = 0.004). Similarly, positive colonoscopy results were found to be more frequent among patients using AC-AA (p = 0.019). While premalignant lesions were more frequently diagnosed in male patients (23% to 10.2%), the results were also statistically significant (p = 0.002). Anticoagulant administration did not contribute to the increase in preneoplastic lesion rates (15.57% to 15.55%). Malignant pathology, which was seen in 8 male patients, was more common among male patients yet it was not statistically significant (p = 0.081). However, compared to 3 patients who did not use AC-AA, malignant pathology was seen more frequently in 9 patients who were on AC-AA and the figure was statistically significant (p = 0.009).

Conclusions
The AC-AA administration in asymptomatic patients over 50 with IDA who have had colonoscopy screening increases the rate of colorectal malignancy diagnosis, while it leads to no change in the rate of preneoplastic lesion detection. Nevertheless, male sex is a factor that increases the possibility of preneoplastic lesion detection.