title: Variations in hemoglobin before colorectal cancer diagnosis.
abstract: We have conducted the present case-control study to examine whether long-term variations in blood hemoglobin (Hb) levels within the normal range could detect subtle gastrointestinal bleeding in the early development of colorectal cancer (CRC). A total of 1074 CRC cases aged 45-75 years that have been diagnosed with CRC and had normal Hb levels were frequency matched for age and sex with cancer-free individuals at a ratio of 10 controls per case. Our retrospective analysis indicates that starting from 4 years prior to cancer diagnosis, a progressive significant (P<0.001) decrement in Hb levels (0.28 g/dl per 6 months) was found among cases but not among controls. CRC patients were characterized in an on-going, long-term, logarithmic decrement in Hb levels. Such small changes within the normal Hb range could be missed by health providers, but automatically detected by computerized alert algorithms..
authors.affiliation: Maccabi Healthcare Services, Tel Aviv, Israel. goldst_in@mac.org.il
authors.forename: Inbal
authors.initials: I
authors.lastname: Goldshtein
authors.forename: Uri
authors.initials: U
authors.lastname: Neeman
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chodick
authors.forename: Varda
authors.initials: V
authors.lastname: Shalev
mesh_terms: D000368:Aged; D000465:Algorithms; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000097:blood / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D006454:Hemoglobins