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GI Malignancy Weight Loss — RACP Adult Medicine MCQ

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EasyGastroenterologyGI Malignancy Weight LossRACP Adult Medicine

A 70-year-old man presents with 12 kg unintentional weight loss over 6 months, early satiety, and iron deficiency anaemia (Hb 95 g/L, ferritin 8 μg/L). He has no vomiting or dysphagia. Faecal occult blood is positive. He has not had a colonoscopy. What is the most likely underlying cause?

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Correct answer: C — Gastrointestinal malignancy

Unintentional weight loss >5% over 6 months with iron deficiency anaemia and positive FOBT in a 70-year-old man is GI malignancy (colorectal cancer) until proven otherwise. Urgent colonoscopy (and upper GI endoscopy for iron deficiency) is required. CT chest/abdomen/pelvis for staging if malignancy found. Iron deficiency in a male over 50 always warrants GI investigation.

Reference: Cancer Council Australia – 2024; eTG Gastrointestinal 2024