Endocrine Abstracts

Introduction: That acromegaly may cause cancer remains an unsolved issue. Aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in a nationwide multicenter cohort study in Italy on acromegalic patients who have been treated in the somatostatin-receptor ligands era.

Methods and design: We have evaluated the prevalence of neoplasia from a series of 1512 patients who were proactively followed in 24 tertiary referral centers in Italy. They were 624 (41.2%) men (median age at diagnosis 42 years) and 888 (58.8%) women (median age at diagnosis 47 years). Cancer registrations were coded using the ICD-9, and data were compared to the general Italian population using the cancer registry AIRTUM.

Results: SIR for all cancers was increased compared to the general Italian population (1.41; 95%CI, 1.18–1.68, P<0.001). In female patients, incidence of all malignancies was increased (SIR 1.51; 95% CI, 1.20–1.91, P<0.001), as was incidence of thyroid cancer, colorectal cancer, and breast cancer. In male patients, incidence of all malignancies was increased (SIR 1.29; 95% CI, 0.99–1.7), as was incidence of thyroid cancer, kidney cancer, and colorectal cancer. In multivariable analysis, factors significantly associated with an increased risk of cancer were age and family history of cancer.

Conclusions: We found evidence that acromegaly is associated with a moderate increase in cancer risk. This may explain why previous underpowered studies failed to demonstrate it. Much of the risk is attributable to thyroid and colon cancer in both genders, breast cancer in women, and kidney cancer in men.