Elif Tutku Durmuş1, Ayşegül Atmaca2, Ramis Çolak2, Buğra Durmuş2. 1. Ondokuz Mayis University, Faculty of Medicine, Department of Endocrinology and Metabolism, Samsun, Turkey. tutkueser@yahoo.com. 2. Ondokuz Mayis University, Faculty of Medicine, Department of Endocrinology and Metabolism, Samsun, Turkey.
Abstract
PURPOSE: To investigate the prevalence of cancer in patients with acromegaly and the variables associated with malignant and premalignant lesions detected by cancer screening. METHODS: The data of 214 patients diagnosed with acromegaly in our institution were evaluated retrospectively. Prevalence of cancer was compared with national rates to estimate standardized incidence ratios (SIRs). The relationships of malignant and premalignant lesions detected by cancer screening with demographic, clinical, and radiological variables were also analyzed. RESULTS: Cancer was detected in 24 (13.4%) of 179 patients enrolled in the study. Compared to the general population, the incidence of all malignancies was increased in both women and men with acromegaly (SIR: 4.78, 95% CI: 2.43-8.53, p = 0.002 and SIR: 8.97, 95% CI: 5.51-14.7, p < 0.001, respectively). The most common cancers were thyroid, colorectal, breast, kidney, gastric, and testicular cancer, respectively. Duration of disease was the only independent risk factor for the development of cancer (OR: 1.007, 95% CI: 1.002-1.011, p = 0.002). Malignant/premalignant lesions were detected in 21.5% of the patients with a colonoscopy scanning procedure and in 20.8% with an esophagogastroduodenoscopy procedure, and current age was found to be higher among the patients with malignant/premalignant lesions (p = 0.023 and p = 0.003, respectively). Breast cancer was detected in 3.7% of screening tests performed with mammography. CONCLUSION: In this study, it was shown that the prevalence of cancer increases with acromegaly and this increase is associated with disease duration. Considering the increase in the number of premalignant lesions, the scope of cancer screening recommendations in the guidelines should be expanded to ensure early diagnosis.
PURPOSE: To investigate the prevalence of cancer in patients with acromegaly and the variables associated with malignant and premalignant lesions detected by cancer screening. METHODS: The data of 214 patients diagnosed with acromegaly in our institution were evaluated retrospectively. Prevalence of cancer was compared with national rates to estimate standardized incidence ratios (SIRs). The relationships of malignant and premalignant lesions detected by cancer screening with demographic, clinical, and radiological variables were also analyzed. RESULTS: Cancer was detected in 24 (13.4%) of 179 patients enrolled in the study. Compared to the general population, the incidence of all malignancies was increased in both women and men with acromegaly (SIR: 4.78, 95% CI: 2.43-8.53, p = 0.002 and SIR: 8.97, 95% CI: 5.51-14.7, p < 0.001, respectively). The most common cancers were thyroid, colorectal, breast, kidney, gastric, and testicular cancer, respectively. Duration of disease was the only independent risk factor for the development of cancer (OR: 1.007, 95% CI: 1.002-1.011, p = 0.002). Malignant/premalignant lesions were detected in 21.5% of the patients with a colonoscopy scanning procedure and in 20.8% with an esophagogastroduodenoscopy procedure, and current age was found to be higher among the patients with malignant/premalignant lesions (p = 0.023 and p = 0.003, respectively). Breast cancer was detected in 3.7% of screening tests performed with mammography. CONCLUSION: In this study, it was shown that the prevalence of cancer increases with acromegaly and this increase is associated with disease duration. Considering the increase in the number of premalignant lesions, the scope of cancer screening recommendations in the guidelines should be expanded to ensure early diagnosis.
Authors: Laurence Katznelson; Edward R Laws; Shlomo Melmed; Mark E Molitch; Mohammad Hassan Murad; Andrea Utz; John A H Wass Journal: J Clin Endocrinol Metab Date: 2014-10-30 Impact factor: 5.958
Authors: A Giustina; P Chanson; M D Bronstein; A Klibanski; S Lamberts; F F Casanueva; P Trainer; E Ghigo; K Ho; S Melmed Journal: J Clin Endocrinol Metab Date: 2010-04-21 Impact factor: 5.958
Authors: D Baris; G Gridley; E Ron; E Weiderpass; L Mellemkjaer; A Ekbom; J H Olsen; J A Baron; J F Fraumeni Journal: Cancer Causes Control Date: 2002-06 Impact factor: 2.506