Endocrine Abstracts

Objective: Acromegaly is characterized by chronic hypersecretion of growth hormone (GH) with increased concentration of IGF-1. There have been controversial debates over the question whether elevated GH levels indicate high risk of developing colorectal neoplasm. There is no clear guideline indicating the need for colorectal cancer screening for acromegalics. We evaluated the colonoscopic findings in our series of patients to analyze the prevalence of risk. Should patients with acromegaly undergo screening for colorectal cancer?

Methods: Full-length colonoscopy was performed on 24 patients within one week after transsphenoidal surgery. The study includes 13 male and 11 female aged 27–62 years. We analyzed the colonoscopic findings - taking histological, hormonal and clinical data into account.

Results: All of the patients were asymptomatic prior to colonoscopy. None of the patients had a positive family history of colorectal cancer. 3 patients showed normal findings, 3 patients were diagnosed with diverticulosis, 2 patients showed inflammatory lesions, 1 patient showed parasite infestation. 8 patients were detected with multiple polyps. 7 patients showed premalignant adenomas. In this respect IGF-1 levels and duration of disease were similar to those with no precancerous lesions. Mean time between symptom onset and diagnosis was estimated as 10 years.

Conclusion: In our series we could detect a high prevalence of premalignant tubulovillous adenomas (7/24) and hyperplastic polyps (8/24) in patients with acromegaly. The results suggest the necessity for routine colorectal cancer screening in this group of patients.