Doctors Need To Stop Ignoring This Common Cancer Sign

“Anticoagulants don’t make people bleed …”

Feb 14, 2020 |

MedScape – Bleeding from the lower gastrointestinal (GI) tract shouldn’t be seen as simply a manageable adverse effect of oral anticoagulation (OAC) for atrial fibrillation (AF). [Commonly prescribed OACs include Pradaxa, Xarelto, and Eliquis.]

Rather, it’s a red flag that the patient may be facing a much bigger threat, say researchers based on their observational study.

The absolute risk for lower-GI bleeding in a large national cohort of patients with AF who started on OAC was less than 1% over 6 months, regardless of age, and substantially less than 1% in patients 65 years and younger.

But those few with such bleeding showed a 10- to 15-fold increased 1-year risk for a diagnosis of colorectal cancer if they were older than 65, and 24 times that risk if they were 65 or younger, compared with those without lower-GI bleeding on OAC.

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“Patients should be informed when initiating treatment with anticoagulants that blood in the stool should always lead to consulting their treating physician, and not be ignored as merely a benign consequence of treatment,” Peter Vibe Rasmussen, MD, University of Copenhagen, Hellerup, Denmark, told | Medscape Cardiology.

“Our study included patients with bleeding severe enough for hospital contact. However, we think our data support that all eligible patients presenting with a sign or symptom of lower GI bleeding should be offered examinations to rule out cancer,” he said.

Only 61% of the youngest and less than 40% of the oldest patients with lower GI bleeds underwent endoscopy to investigate the cause …

Source: GI Bleeding on Oral Anticoagulants in Atrial Fib Foremost a Colon Cancer Red Flag – Medscape – Feb 14, 2020.


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