Acromegaly colonoscopy findings series#

Moreover, in human studies, there is convincing evidence that circulating IGF1 concentrations at the higher limit of the normal range are linked with an increased risk of several types of cancers, although the excess risk seems moderate ( Renehan et al. A wealth of preclinical data supports the view that the GH-IGF system plays an important role in cancer development and progression ( Loeper & Ezzat 2008, Pollak 2008, Weroha & Haluska 2012, Brahmkhatri et al. The fact that acromegaly may cause cancer, and that mortality due to cancer contributes to shorten survival of patients with acromegaly, remains an unsolved issue ( Melmed 2001, Loeper & Ezzat 2008, Boguszewski & Ayuk 2016). Mortality was higher in patients with persistently active disease, and IGF1 levels at diagnosis, GH at the last follow-up, cancer and pituitary radiotherapy were independent predictors of mortality ( Arosio et al. 2014) The impact of acromegaly on life expectancy comes mainly through cardiovascular and cerebrovascular events, since diabetes mellitus and hypertension are frequent complications of GH and IGF1 excess ( Melmed 2001) Recently, we did a large-scale epidemiological analysis on 1512 acromegalic Italian patients and found that vascular disease and cancer were the main causes of death. 2010), reflecting improved treatment modalities that became available in recent years, such as somatostatin-receptor ligands (SRL) and pegvisomant ( Bogazzi et al. Recent population-based studies have showed that acromegalic patients have lower standard mortality ratios than previously reported ( Sherlock et al. However, the effective control of GH and IGF1 excess is able to reduce considerably the burden of disease. In conclusion, we found evidence that acromegaly in Italy is associated with a moderate increase in cancer risk.Īcromegaly is an uncommon disease sustained by hypersecretion of GH and IGF1 and is associated with remarkable complications that may reduce life expectancy of these patients ( Melmed 2009, Katznelson et al. In multivariate analysis, the factors significantly associated with an increased risk of malignancy were age and family history of cancer, with a non-significant trend for the estimated duration of acromegaly before diagnosis. The exclusion of 11 cancers occurring before diagnosis of acromegaly (all in women) did not change remarkably the study outcome. The SIRs for all cancers was significantly increased compared to the general Italian population (expected: 88, SIR 1.41 95% CI, 1.18–1.68, P < 0.001). Cancer was diagnosed in 124 patients, 72 women and 52 men. It was evaluated the incidence of cancer in an Italian nationwide multicenter cohort study of 1512 acromegalic patients, 624 men and 888 women, mean age at diagnosis 45 ± 13 years, followed up for a mean of 10 years (12573 person-years) in respect to the general Italian population.

Acromegaly colonoscopy findings series#

The aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in acromegaly on a large series of acromegalic patients managed in the somatostatin analogs era. It is debated if acromegalic patients have an increased risk to develop malignancies.