A middle-aged male presented with history of fatigue and tiredness. On investigating, he had a hemoglobin of 8g/dL and MCV of 110 fl with the peripheral smear showing macrocytes and hypersegmented neutrophils. Which of the following is the most likely cause of the findings in this patient?

Ancylostoma duodenale (hookworm) infestation and colon cancer can be associated with chronic blood loss leading to iron deficiency (microcytic hypochromic anemia). Chronic renal failure can lead to anemia of chronic inflammation which usually presents with normocytic normochromic anemia. Chronic alcoholism can be associated with folic acid deficiency which causes megaloblastic anemia (macrocytosis, elevated MCV, hypersegmented neutrophils).