{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T04:29:03Z","timestamp":1786422543873,"version":"build-2736575974"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003483","name":"Hebrew University of Jerusalem","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003483","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To characterize age- and sex-specific patterns of microcytic anemia during adolescence and to estimate the potential yield of screening across age groups.\u00a0We performed a retrospective Electronic Health Record (EHR)-based study using data from Clalit Health Services (CHS), the largest health maintenance organization in Israel. Adolescents aged 12\u201318\u00a0years with at least one hemoglobin and mean corpuscular volume (MCV) measurement between 2003 and 2023 were included. Individuals with hereditary, hemolytic, or chronic inflammatory causes of anemia were excluded. Microcytic anemia was defined as hemoglobin\u2009&lt;\u200912\u00a0g\/dL for females and\u2009&lt;\u200913\u00a0g\/dL for males with MCV\u2009&lt;\u200978 fL. Age- and sex-specific prevalence was calculated among tested adolescents and in the total CHS-insured population. Screening efficiency was assessed using the number needed to test (NNT).\u00a0A total of 1,306,623 test records were analyzed. Among females, the prevalence of microcytic anemia increased with age, from 7.8% at ages 12\u201313 to 12.5% at ages 17\u201318. Among males, prevalence declined from 18.9% at age 12\u201313 to 2.1% at ages 17\u201318. This resulted in a reversal of the sex distribution of microcytic anemia prevalence during mid-adolescence, with females exceeding males from approximately age 15 onward. The NNT increased with age among males and remained relatively stable during mid- to late adolescence among females.<\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    :\u00a0Microcytic anemia demonstrates distinct age- and sex-specific patterns during adolescence. The increasing prevalence among females and declining prevalence among males suggest that targeted screening of adolescent girls during mid-adolescence may be an efficient strategy for identifying microcytic anemia, a condition commonly associated with iron deficiency in this age group.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is Known:<\/jats:bold>\n                              \u2022\n                              <jats:italic>Iron deficiency anemia remains common in adolescents, particularly among females in high-income countries.<\/jats:italic>\n                              \u2022\n                              <jats:italic>Prevalence estimates vary widely due to differences in definitions, populations, and study designs.<\/jats:italic>\n                              \u2022\n                              <jats:italic>There are no universally accepted guidelines for routine anemia screening in adolescents, and current practices are inconsistent.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is New:<\/jats:bold>\n                              <jats:italic>\u2022 A reversal in sex-specific prevalence of microcytic anemia occurs during mid-adolescence, with higher rates in females from approximately age 15 onward.<\/jats:italic>\n                              \u2022\n                              <jats:italic>Screening efficiency, quantified by number needed to test, varies substantially by age and sex, supporting targeted screening of adolescent girls at age 14.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-026-07279-6","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:48:31Z","timestamp":1785851311000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age- and sex-specific patterns of microcytic anemia in adolescence: implications for screening"],"prefix":"10.1007","volume":"185","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0017-6332","authenticated-orcid":false,"given":"Tal","family":"Ben-Ami","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avigail","family":"Eisenberg-Wygoda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoshana","family":"Revel-Vilk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"issue":"10159","key":"7279_CR1","doi-asserted-by":"publisher","first-page":"1859","DOI":"10.1016\/S0140-6736(18)32335-3","volume":"392","author":"DALYs GBD, Collaborators H","year":"2018","unstructured":"DALYs GBD, Collaborators H (2018) Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. 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The authors have no relevant financial or nonfinancial interests to disclose. This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Kaplan Institutional Review Board (No. KMC-24\u20130089). The requirement for informed consent was waived by the Kaplan IRB given that the study was retrospective and only deidentified data was used. All content was reviewed, verified, and approved by the authors, who take full responsibility for the accuracy and integrity of the manuscript.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"639"}}