Prevalence of Non-anemic Iron Deficiency in Cancer Patients Before Initiation of Therapy and It’s Correlation to Health-related Quality of Life

Abstract

Background: Non-anemic iron deficiency (NAID) is a subclinical state in the serum iron continuum that leads to depletion of iron reserves, making the victim prone to iron-deficient erythropoiesis. Because of the complexity in cancer care, and the multicriteria approach to the monitoring of iron status, deteriorating health-related quality of life (HRQL) is commonplace among cancer patients. Objective: To determine the prevalence of NAID in cancer patients before initiation of therapy and its correlation to (HRQL) at (KNH). Methods: This was a cross-sectional analytical study carried out in KNH among adult cancer patients on an initial clinic visit. 331 participants were selected through consecutive sampling. The FACIT-AN tools were used in interviews and samples of blood obtained in vacutainer, to be run in SYSMEX XN- 1000 analyzer to produce reportable reticulocyte hemoglobin content (CHr). Results: Data analysis was done in R-program. Descriptive, inferential statistics; multivariate regression was applied to determine associations between variables. The prevalence of NAID was (2.4%). All the HRQL domains statistically predicted CHr levels, F (4, 106) = 2.789, p=.030, R2 = .309. There was a significant difference in the observed CHr mean in solid tumors, Welch’s F (7, 172.914) = 2.906, p=.008. The esophageal, colorectal, cervical cancer had statistically significantly low mean CHr mean compared to other tumors. Conclusion: The prevalence of NAID before initiation of therapy was (2.4%). Participants with tumors of gynecological and gastrointestinal descent were more predisposed to NAID than other tumors. This study finding acquiesces to the rejection of the null hypothesis that HRQL has no significant association with Serum Iron in cancer patients before therapy initiation. Recommendation: Optimal timing for CHr assay should be incorporated in cancer screening protocols for early NAID detection and its management. A public health strategy is instituted to promote awareness of the risk for deterioration of HRQL caused by NAID.