New York (Reuters Health) - Cancer incidence is not significantly higher in patients treated for acromegaly compared with the general population, according to a new study.
"Patients diagnosed with acromegaly may be at higher risk of developing various types of cancer, including colorectal cancer. If this should be the case, then it is important to screen for it regularly," Dr. David Petroff, of the University of Leipzig, Germany, told Reuters Health by email.
"If the incidence is not increased, however, then the risks and psychological burden of the screening may outweigh the benefit. Given contradictory statements in the literature and new treatment strategies, it is important to quantify the risk of cancer using high-quality, current data in order to arrive at an informed screening strategy," he added.
Hypersecretion of growth hormone (GH) and elevated levels of insulin-like growth factor 1 (IGF-1) characterize the rare condition known as acromegaly. Furthermore, data suggests a relationship between acromegaly and colorectal, prostate, breast, and thyroid cancer, researchers wrote.
In a study published online August 5 in the Journal of Clinical Endocrinology & Metabolism, Dr. Petroff and colleagues sought to clarify a potential relationship between acromegaly and incidence of cancer compared to the general population.
The study included patients from the German Acromegaly Registry who were treated at seven endocrine centers. Researchers obtained date of cancer diagnosis and type of cancer (colorectal, thyroid, breast, lung, prostate, or other) by interview.
Cancer incidence for the general population was obtained from the German Centre for Cancer Registry Data at the Robert-Koch institute.
The researchers analyzed data for 445 patients and accounted for 6,656 person-years from diagnosis and 28,896 person-years from birth. Of the 42 patients who developed cancer, four had two separate cancer diagnoses. Likewise, subjects diagnosed with cancer were older but did not have increased rates of elevated GH.
When compared to the general population, standardized incidence ratios (SIRs) do not suggest a higher incidence of cancer in patients with acromegaly. However, despite a low sample of subjects with thyroid cancer the SIR was estimated at 2.0.
Dr. Petroff noted in the email, "Physicians should be aware that patients with acromegaly, especially treated with modern methods, may not be at higher risk for cancer. This can help allay fears and suggests that very frequent screening may be unnecessary."
"This study does not provide the definitive answer regarding cancer incidence amongst patients with acromegaly. For one thing, some data were collected retrospectively and they only reflect the situation in Germany. It would be well worth performing a multinational prospective study. It would also be very interesting, though challenging, to study the potential effects of the very high levels of growth hormone that patients have in the years prior to diagnosis of acromegaly," Dr. Petroff continued.
Three coauthors reported relationships with pharmaceutical companies outside this study.
SOURCE: http://bit.ly/1MsEOg6
J Clin Endocrinol Metab 2015.
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