TY - JOUR
T1 - Cancer Incidence in Patients with Acromegaly
T2 - A cohort study and meta-analysis of the literature
AU - Dal, Jakob
AU - Leisner, Michelle Z
AU - Hermansen, Kasper
AU - Farkas, Dóra Körmendiné
AU - Bengtsen, Mads
AU - Kistorp, Caroline
AU - Nielsen, Eigil H
AU - Andersen, Marianne
AU - Feldt-Rasmussen, Ulla
AU - Dekkers, Olaf M
AU - Sørensen, Henrik Toft
AU - Jørgensen, Jens Otto Lunde
N1 - This article has been found as a 'Free Version' from the Publisher on September 4th 2018. When the access to the article closes, please notify vbn@aub.aau.dk
PY - 2018
Y1 - 2018
N2 - Context: 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.Design: 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.Results: 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.Conclusions: 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.
AB - Context: 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.Design: 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.Results: 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.Conclusions: 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.
UR - https://academic.oup.com/jcem/article-pdf/103/6/2182/25011486/jc.2017-02457.pdf
UR - http://www.scopus.com/inward/record.url?scp=85048685678&partnerID=8YFLogxK
U2 - 10.1210/jc.2017-02457
DO - 10.1210/jc.2017-02457
M3 - Journal article
C2 - 29590449
SN - 0021-972X
VL - 103
SP - 2182
EP - 2188
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 6
ER -