Acromegaly has been associated with increased risk of cancer morbidity and mortality, but research findings remain conflicting and population-based data are scarce. We therefore examined whether patients with acromegaly are at higher risk of cancer.
A nationwide cohort study (1978-2010) including 529 acromegaly cases was performed. Incident cancer diagnoses and mortality were compared to national rates estimating standardized incidence ratios (SIRs). A meta-analysis of cancer SIRs from 23 studies (including the present one) was performed.
The cohort study identified 81 cases of cancer after exclusion of cases diagnosed within the first year (SIR 1.1 [95% confidence interval (CI): 0.9-1.4]). SIRs were 1.4 [95% CI: 0.7-2.6] for colorectal cancer, 1.1 [95% CI: 0.5-2.1] for breast cancer, and 1.4 [95% CI: 0.6-2.6] for prostate cancer. While overall mortality was increased in acromegaly (SIR 1.3 [95% CI: 1.1-1.6]), cancer-specific mortality was not. The meta-analysis yielded a SIR of overall cancer of 1.5 [95% CI: 1.2-1.8]. SIRs were elevated for colorectal cancer: 2.6 [95% CI: 1.7-4.0], thyroid cancer: 9.2 [95% CI: 4.2-19.9], breast cancer: 1.6 [1.1-2.3], gastric cancer: 2.0 [95% CI: 1.4-2.9], and urinary tract cancer: 1.5 [95% CI: 1.0-2.3]). In general, cancer SIR was higher in single-center studies and in studies with < 10 cancer cases.
Cancer incidence rates were slightly increased in acromegaly patients in our study and this was supported by the meta-analysis of 23 studies, although it also suggested the presence of selection bias in some earlier studies.
The Journal of clinical endocrinology and metabolism. 2018 Mar 23 [Epub ahead of print]
Jakob Dal, Michelle Z Leisner, Kasper Hermansen, Dóra Körmendiné Farkas, Mads Bengtsen, Caroline Kistorp, Eigil H Nielsen, Marianne Andersen, Ulla Feldt-Rasmussen, Olaf M Dekkers, Henrik Toft Sørensen, Jens Otto Lunde Jørgensen
Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark., Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark., Department of Medicine, Sydvestjysk Sygehus, Esbjerg, Denmark., Department of Internal Medicine, Copenhagen University Hospital, Herlev, Denmark., Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark., Department of Endocrinology, Odense University Hospital, Odense, Denmark., Department of Endocrinology, National University Hospital Rigshospitalet, Copenhagen, Denmark.