Anticoagulants and Gastrointestinal Cancer Detection

Share this content:
The test could represent a previously under-recognized modality leading to the early detection of a GI malignancy.
The test could represent a previously under-recognized modality leading to the early detection of a GI malignancy.

Patients with gastrointestinal (GI) cancer frequently present with GI bleeding. GI bleeding (GIB) may be classified based on location: upper (esophagus, stomach or duodenum) versus lower (jejunum, ileum, large intestine). 

Patients with upper GIB may present with hematemesis and melena (dark, tarry stools) while lower GIB patients may present with hematochezia or bright red blood per rectum.

Depending on the stage and type of GI malignancy, the patient may not complain of symptoms and the lesion may not be detected if they are non-compliant or do not qualify for the current screening guidelines.

These patients with previously undetected GI malignancy my inadvertently undergo what has been called an “antigocoagulation GI stress-test” when started on antiplatelets and/or anticoagulants.1

This could represent a previously under-recognized modality leading to the early detection of a GI malignancy.

RELATED: Hot Topics From the 2015 Gastrointestinal Cancers Symposium

Patients with an occult GI malignancy who are otherwise asymptomatic may present with signs and symptoms of GIB when initiated on anticoagulation that would have been previously absent had it not been for a new medication.

Consequently, these patients may require earlier endoscopic investigation to evaluate a potential source of bleeding.

Endoscopic procedures that potentially could be utilized include esophagogastroduodenoscopy (EGD), endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), small bowel enteroscopy, and colonoscopy.

A study conducted by Asiimwe and colleages found that patients receiving warfarin or clopidogrel who experienced a GI bleed were approximately 6 times more likely to be diagnosed with a GI malignancy compared to those without GI bleeding.2

In addition, the increased risk of GI cancer detection was the most prominent within the first 6 months of the first episode of GI bleeding2 which correlates previous data showing most GI bleeding occurs within the first year of anticoagulant/antiplatelet initiation.1

Page 1 of 2

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs

Sign Up for Free e-newsletters