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Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Cancer Incidence in Patients With Acromegaly: A Cohort Study and Meta-Analysis of the Literature

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

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  • 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
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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 to 2010) including 529 acromegaly cases was performed. Incident cancer diagnoses and mortality were compared with 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 to 1.4]. SIRs were 1.4 (95% CI, 0.7 to 2.6) for colorectal cancer, 1.1 (95% CI, 0.5 to 2.1) for breast cancer, and 1.4 (95% CI, 0.6 to 2.6) for prostate cancer. Whereas overall mortality was elevated in acromegaly (SIR 1.3; 95% CI, 1.1 to 1.6), cancer-specific mortality was not. The meta-analysis yielded an SIR of overall cancer of 1.5 (95% CI, 1.2 to 1.8). SIRs were elevated for colorectal cancer, 2.6 (95% CI, 1.7 to 4.0); thyroid cancer, 9.2 (95% CI, 4.2 to 19.9); breast cancer, 1.6 (1.1 to 2.3); gastric cancer, 2.0 (95% CI, 1.4 to 2.9); and urinary tract cancer, 1.5 (95% CI, 1.0 to 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 elevated in patients with acromegaly in our study, and this finding was supported by the meta-analysis of 23 studies, although it also suggested the presence of selection bias in some earlier studies.

OriginalsprogEngelsk
TidsskriftThe Journal of clinical endocrinology and metabolism
Vol/bind103
Udgave nummer6
Sider (fra-til)2182-2188
Antal sider7
ISSN0021-972X
DOI
StatusUdgivet - 1 jun. 2018

ID: 55074271