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Year : 2021  |  Volume : 4  |  Issue : 1  |  Page : 166-167

Prevalence of anemia among patients with cancer: A complex phenomenon

Department of Community Medicine, SHKM Government Medical College, Nuh, Haryana, India

Date of Submission24-Jan-2021
Date of Decision12-Feb-2021
Date of Acceptance13-Feb-2021
Date of Web Publication26-Mar-2021

Correspondence Address:
Neeraj Gour
Professor, Department of Community Medicine, SHKM Government Medical College, Nuh Near Gurgaon, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/crst.crst_18_21

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How to cite this article:
Gour N, Chawla S. Prevalence of anemia among patients with cancer: A complex phenomenon. Cancer Res Stat Treat 2021;4:166-7

How to cite this URL:
Gour N, Chawla S. Prevalence of anemia among patients with cancer: A complex phenomenon. Cancer Res Stat Treat [serial online] 2021 [cited 2021 Jul 27];4:166-7. Available from: https://www.crstonline.com/text.asp?2021/4/1/166/312066

Anemia is a major public health problem in India leading to high maternal morbidity and mortality, low birth weight, and high infant mortality.[1] India has the highest prevalence of anemia in the world. With a population of over one billion, India is home to a large number of people with anemia.[2] Studies have shown that iron deficiency is the most common micronutrient deficiency associated with anemia, followed by folate and vitamin B12 deficiencies.[1]

An array of public health programs for nutrition and health of women, children, and adolescents has been launched in our country. Different interventions (both prophylactic and curative) are being used for high-risk populations to combat this problem. The data from the National Family Health Survey 4[3] suggest that 53.1% of women and 22.7% of men in the age group of 15–49 years are anemic; this shows that we still have a long way to go to address this public health problem. Appropriate strategies have to be devised to rapidly reduce the prevalence of anemia and achieve sustainable development goals.[3]

Cancer is one of the fastest-growing non-communicable diseases in India. Patients with cancer, because of their health problems, experience a poor quality of life (QOL),[4],[5] which may be further aggravated by anemia. Fatigue is one of the most common symptoms experienced by patients with cancer that adversely affects their QOL.[5],[6],[7]

We congratulate Pandey et al.[8] for their article titled, “Prevalence of iron and Vitamin B12 deficiencies and inflammatory anemia in treatment-naive patients with cancer: A cross sectional study.” There are, however, certain issues in the article that warrant further explanation, for example, the evaluation of anemia, the calculation of the odds ratio, and Chi-square test calculation. The authors could have avoided using these terms in the article, since they are not calculated. Deworming plays an important role in the prevention and control of anemia. Therefore, studies aimed at determining the prevalence of anemia should essentially take into account the deworming status of the subjects. Moreover, anemia in patients with cancer can either be cancer-related, treatment-related, or patient-related.[4] Hence, determining the cause of anemia in patients with cancer could help in planning more targeted strategies to combat it. Risk estimation of anemia on the basis of different variables such as the type of cancer, the disease stage, time of detection of cancer, and the treatment modality may further be measured using more evidence-based study designs. A proven causal association of anemia with different types of cancers may provide a better understanding about how to deal with this problem. However, a causal association of anemia with cancer is difficult to prove using a cross-sectional study design.

In the future, we suggest that the authors plan some interventional studies using different preventive, curative, and diagnostic modalities in a bid to produce highly actionable evidence. Like any public health program, screening is the backbone for the early detection of anemia in the general population, including patients with cancer. Hence, strengthening the screening programs for anemia with governmental and non-governmental support is the need of the hour so that anemia can be detected at very early stages and corrective measures can be instituted.

In conclusion, it is fair to say that the prevalence of anemia among patients with cancer is a complex phenomenon to be understood and estimated. It is difficult to distinguish an already existing anemia aggravated by cancer from cancer-induced anemia. Hence, future research should be focused on the preventive & curative modalities, dietary interventions, screening and early detection of anemia among patients with cancer.

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  References Top

Ramachandran P, Kalaivani K. Prevalence of anaemia in India and strategies for achieving Sustainable Development Goals (SDG) target. Proc Indian Natl Sci Acad 2018;84:99-912.  Back to cited text no. 1
WHO 2015: The Global Prevalence of Anaemia; 2011. Available from: http://www.who.int/nutrition/publications/micronutrients/global_prevalence_anaemia…/en/. [Last accessed on 2021 Jan 20].  Back to cited text no. 2
NFHS-4: India Factsheet Ministry of Health and Family Welfare. Available from: http://rchiips.org/nfhs/pdf/NFHS4/India.pdf. [Last accessed on 2021 Jan 20].  Back to cited text no. 3
Raghavan V, Manuprasad A, Sajeev Kumar PB, Raj Z, Shenoy PK, Nair CK. Health-related quality of life in patients with multiple myeloma on novel agents: Report from a tertiary cancer center in rural India. Cancer Res Stat Treat 2018;1:92-5.  Back to cited text no. 4
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Asthana S, Bhatia S, Dhoundiyal R, Labani SP, Garg R, Bhatnagar S. Quality of life and needs of the Indian advanced cancer patients receiving palliative care assessment of the quality of life, problems, and needs of the advanced cancer patient receiving palliative care. Cancer Res Stat Treat 2019;2:138-44.  Back to cited text no. 5
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Singh GK, Varghese L, Menon N, Dale O, Patil V. Cancer-related fatigue and its impact on quality of life in patients with brain tumors - Cross-sectional analysis. Cancer Res Stat Treat 2021;4:44-9.  Back to cited text no. 6
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Abdel-Razeq H, Hashem H. Recent update in the pathogenesis and treatment of chemotherapy and cancer induced anemia. Critical reviews in oncology/hematology. 2020 Jan 1;145:102837.  Back to cited text no. 7
Pandey A, Aryan R, Krishna M, Singh S, Pankaj P. Prevalence of iron and Vitamin B12 deficiencies and inflammatory anemia in treatment naive patients with cancer: A cross sectional study. Cancer Res Stat Treat 2020;3:708-15.  Back to cited text no. 8
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