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BACKGROUND: Patients with unexplained iron deficiencyanemia have a greater prevalence of colonic neoplasia, and should be evaluatedfor a colonoscopy. The approach to patients with anemia without iron deficiencyremains unclear. OBJECTIVE: To compare the prevalence of colonic neoplasia inanemic patients with normal ferritin (>50 ng/mL), to those with ferritin< or =50 ng/mL, and nonanemic individuals. METHODS: Patients referred forcolonoscopy for anemia evaluation were stratified into 3 groups: ferritin <or =50 ng/mL, 51-100 ng/mL, and >100 ng/mL. We compared these groups to eachother, and to asymptomatic nonanemic individuals undergoing screening colonoscopy.The prevalence of advanced colonic neoplasia was determined for each groupusing existing records. RESULTS: During the study period, 414 patients whounderwent colonoscopy for anemia evaluation and 323 nonanemic individuals whounderwent colonoscopy for cancer screening met inclusion criteria. Studysubjects were mostly men. The prevalence of advanced colonic neoplasia insubjects with ferritin 51-100 ng/mL was 7.2% (95% CI 2.4-17.9%), similar to7.9% (95% CI 5.1-11.9%) in those with ferritin < or =50 ng/mL. The incidenceof advanced colonic neoplasia in subjects with ferritin >100 ng/mL was 1.7%(95% CI 0.1-6.6%), similar to 1.2% (95% CI 0.4-3.3%) in the asymptomaticnonanemic group. After adjusting for age, patients with ferritin < or =50ng/mL and 51-100 ng/mL were almost 5 times more likely to harbor advancedcolonic neoplasia than the other groups. The addition of other laboratoryparameters did not improve the predictive value of ferritin. CONCLUSION: Aferritin cutoff of 100 ng/mL can be used to determine the need for colonoscopyin men with anemia. Leggil'articolo