Published in PLOS One on 2026-07-01, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Eden Alemu, Abebe Melis, Alemwosen T/haimanot, Bizunesh Dires, Anteneh Fikrie, Hagos Tesfay, Abdela Amano
Source: PLOS One • DOI 10.1371/journal.pone.0342280
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Anemia is a common and debilitating complication in cancer patients, affecting prognosis, quality of life, and treatment response. The burden of anemia may be higher in resource-limited settings due to nutritional deficiencies and limited healthcare access. However, data on anemia among newly diagnosed cancer patients in Ethiopia remain scarce. This study was aimed to determine the magnitude and predictors of anemia in newly diagnosed adult solid cancer patients in Hawassa, Ethiopia.
A cross-sectional study was conducted among randomly selected 405 newly diagnosed adult solid cancer patients at selected public health facilities in Hawassa City, Ethiopia, from June 2021 to October 2021. Data were collected using structured face-to-face interviews and from medical records. Data were entered into EpiData version 3.1 and exported to SPSS version 26 for analysis. Descriptive statistics were computed for all variables. Binary logistic regression was performed to determine the independent effects of potential explanatory variables on the presence of anemia. Adjusted Odds ratios with 95% confidence intervals were calculated. Statistical significance was set at p-value < 0.05.
The prevalence of anemia was 26.4% (95% CI: 22.1–30.7%), with normocytic anemia (56.1%) being the most common morphological type. Multivariable analysis identified a history of bleeding (AOR = 3.46, 95% CI: 1.94–6.16), advanced cancer stage (AOR = 2.01, 95% CI: 1.20–3.34), and underweight BMI (AOR = 2.14, 95% CI: 1.28–3.55) were significantly associated with anemia. Conversely, higher educational attainment (diploma and above) was protective (AOR = 0.35, 95% CI: 0.13–0.93).
Anemia affects over one-quarter of newly diagnosed solid cancer patients in Hawassa, with advanced-stage disease, bleeding history, and decreasing body mass index as significant risk factors. These findings highlight the need for routine anemia screening at diagnosis, nutritional interventions, and early bleeding management in oncology settings.
Introduction
Cancer is a major public health concern worldwide, characterized by the uncontrolled proliferation and spread of abnormal cells that can invade surrounding tissues, metastasize to distant organs, and result in death [1,2]. Globally, cancer caused 10 million deaths in 2020, with 19.3 million new cases [3]. In Ethiopia and other low- and middle-income countries (LMICs), cancer burden is rising due to aging, increased risk factors, and poor access to early detection and treatment [4].
Anemia is a common and debilitating complication in cancer patients, significantly impacting prognosis, quality of life, and treatment response [5]. It is characterized by reduced hemoglobin (Hb) concentration, red blood cell (RBC) count, or packed cell volume, leading to impaired oxygen delivery to tissues [6]. The National Comprehensive Cancer Network (NCCN) classifies anemia as mild (Hb 10–lower limit of normal g/dL), moderate (Hb 8– < 10 g/dL), severe (Hb 6.5– < 8 g/dL), and life-threatening (Hb < 6.5 g/dL) [7]. Cancer-related anemia (CRA) is multifactorial, influenced by tumor-induced inflammation, chemotherapy-induced myelosuppression, blood loss, nutritional deficiencies, and chronic disease states [8,9]. Based on RBC morphology, CRA can be microcytic (commonly due to iron deficiency), normocytic (linked to chronic disease), or macrocytic (resulting from vitamin B12 and folic acid deficiencies) [9,10].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Eden Alemu, Abebe Melis, Alemwosen T/haimanot, Bizunesh Dires, Anteneh Fikrie, Hagos Tesfay, Abdela Amano. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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