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INTRODUCTION Colorectal cancer and anaemia

ELEVATED ZINC PROTOPORPHYRIN (ZPP) IS AS SENSITIVE AS SERUM FERRITIN IN THE DETECTION OF COLORECTAL CANCER IN PATIENTS WITH ANAEMIA Mazhar K., Leung E., Ramcharan S., Tripuraneni G., Francombe J. Department of General Surgery Warwick Hospital, Warwick, CV34 5BW. INTRODUCTION

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INTRODUCTION Colorectal cancer and anaemia

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  1. ELEVATED ZINC PROTOPORPHYRIN (ZPP) IS AS SENSITIVE AS SERUM FERRITIN IN THE DETECTION OF COLORECTAL CANCER IN PATIENTS WITH ANAEMIAMazhar K., Leung E., Ramcharan S., Tripuraneni G., Francombe J.Department of General SurgeryWarwick Hospital, Warwick, CV34 5BW • INTRODUCTION • Colorectal cancer and anaemia • Anaemic patients with low serum ferritin have a colorectal cancer detection rate of approximately 5-10%. Patients are routinely investigated with gastroscopy and colonoscopy. • Elevated ZPP (normal <70 umol/mol Haem) levels are a sensitive marker of iron deficiency and are considerably cheaper than serum ferritin measurements. Reagents cost for serum ferritin £2.40 Vs ZPP £0.85 per patient sample. • Elevated ZPP has not been previously evaluated in colon cancer detection • AIM • To establish the relationship between colon cancer detection rate and anaemic patients with elevated ZPP. • METHODS • Retrospective study, January 2002 to September 2007 using the prospective ‘Endoscribe’ database • Over 1300 sets of data analysed • Statistical significance was analysed using Chi square test • RESULTS • 600 patients had both an OGD and colonoscopy • 185 patients had anaemia and serum ZPP Pathology ZPP >200 ZPP < 200 Total Angiodysplasia 1 (1.9%) 3 (2.3%) 4 (2.2%) Polyp ( Non-malignant) 5 (9.3%) 9 (6.9%) 14 (7.6%) Carcinoma 6 (11.1%) 9 (6.9%) 15 ( 8.1%) Other 42 (77.8%) 110 (84%) 152 (82.2%) Total 54 131 185 CONCLUSIONS • ANAEMIC PATIENTS WITH ELEVATED ZPP LEVELS HAVE SIMILAR COLORECTAL CANCER DETECTION RATES AS ANAEMIC PATEINTS WITH DECREASED SERUM FERRITIN • ZPP LEVELS ARE CHEAPER THAN SERUM FERRITIN MEASUREMENTS • ALTHOUGH NO SIGNIFICANT DIFFERENCE IN DETECTION RATE IN PATIENTS WITH NORMAL OR ELEVATED ZPP, THERE IS A TREND OF INCREASING CANCER DETECTION WITH INCREASING ZPP.

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