Acromegaly, colonic polyps and carcinoma

Jenkins, Paul J.; Fairclough, Peter D.; Richards, Toby; Lowe, David; Monson, John P.; Grossman, Ashley; Wass, John; Besser, Michael

doi:10.1046/j.1365-2265.1997.1911029.x

Cited by 198 publications

(156 citation statements)

References 21 publications

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“…Several previous studies have suggested that these patients are also at an increased risk of neoplasia, especially colorectal cancer and pre-malignant adenomatous polyps, although the degree of risk remains under debate (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). In our original series, we observed 5% to have a carcinoma and 25% to have one or more adenomas (11). Similar findings have been reported by other groups (12).…”

Section: Introductionsupporting

confidence: 78%

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Repeated colonoscopic screening of patients with acromegaly: 15-year experience identifies those at risk of new colonic neoplasia and allows for effective screening guidelines

Dworakowska

Gueorguiev²,

Kelly³

et al. 2010

European Journal of Endocrinology

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Objective: It is suggested that patients with acromegaly have an increased risk of colorectal cancer and pre-malignant adenomatous polyps. However, the optimum frequency with which colonoscopic screening should be offered remains unclear. Design: To determine the optimum frequency for repeated colonoscopic surveillance of acromegalic patients. Methods: We retrospectively reviewed the case records of all patients with acromegaly seen in our centre since 1992: 254 patients had at least one surveillance colonoscopy, 156 patients had a second surveillance colonoscopy, 60 patients had a third surveillance colonoscopy and 15 patients had a fourth surveillance colonoscopy. Results: The presence of hyperplastic or adenomatous polyps was assessed in all patients, while one cancer was detected at the second surveillance. At the third surveillance, mean (GS.D.) serum IGF1 levels (ng/ml) in patients with hyperplastic polyps were significantly higher than those with normal colons (P!0.05). The presence of an adenoma rather than a normal colon at the first colonoscopy was associated with a significantly increased risk of adenoma at the second (odds ratio (OR) 4.4, 95% confidence interval (CI) 1.9-10.4) and at the third (OR 8.8, 95% CI 2.9-26.5) screens. Conversely, a normal colon at the first surveillance gave a high chance of normal findings at the second (78%) or third surveillance (78%), and a normal colon at the second colonoscopy was associated with normality at the third colonoscopy (81%). Conclusions: Repeated colonoscopic screening of patients with acromegaly demonstrated a high prevalence of new adenomatous and hyperplastic colonic polyps, dependent on both the occurrence of previous polyps and elevated IGF1 levels.

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Section: Introductionsupporting

confidence: 78%

“…The advantage of the present study is that it reflects the experience of a single large cohort of patients from a single institution, and all the colonoscopies, except two, were performed by the same skilled operator, who visualised the entire colon in 99% of procedures. For less experienced operators, the success rate is only 70% (11).…”

Section: Discussionmentioning

confidence: 99%

Repeated colonoscopic screening of patients with acromegaly: 15-year experience identifies those at risk of new colonic neoplasia and allows for effective screening guidelines

Dworakowska

Gueorguiev²,

Kelly³

et al. 2010

European Journal of Endocrinology

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show abstract

“…Despite the variation of polyps and cancer prevalence at this site (9-38%) in different series (12)(13)(14)(15)(16), the correlation between acromegaly and tumors is frequently observed, and many studies have shown that an increase in IGF-I is correlated with an increase in the prevalence of polyps (12,13), adenomas (17) and proliferation of colon epithelium cells (12).…”

Section: Discussionmentioning

confidence: 99%

Frequency of various types of neoplasia in a group of acromegalic patients

Bolfi

Miot

Resende

et al. 2013

Arq Bras Endocrinol Metab

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Objective: To determine the frequency of colon cancer, primary hyperparathyroidism, thyroid tumor, and skin cancer in all acromegalic patients in follow-up at the Clinics Hospital -Botucatu Medical School, from 2005 to 2011. Subjects and methods: These patients were evaluated retrospectively for colon cancer, primary hyperparathyroidism, dermatological, and thyroid tumors. Results: Of 29 patients included at the beginning of the study, two were excluded. Among 19 patients submitted to colonoscopy, one presented colon adenocarcinoma (5%). Thyroid nodules were present in 63% of patients, and papilliferous carcinoma was confirmed in two patients (7,7%). Four patients were confirmed as having primary hyperparathyroidism (15%). The most common dermatologic lesions were thickened skin (100%), acrochordons (64%), epidermal cysts (50%), and pseudo-acanthosis nigricans Dentre os 19 pacientes submetidos à colonoscopia, um apresentou adenocarcinoma de cólon (5%). Nódulos de tireoide estiveram presentes em 65% dos pacientes e carcinoma papilífero, em dois deles (7,7%). Quatro pacientes apresentaram hiperparatireoidismo primário (15%). A maioria das lesões de pele foram: espessamento (100%), acrochordons (64%), cistos epidérmicos (50%), pseudoacantose nigricans (50%) e apenas um paciente apresentou carcinoma basocelular. Conclusão: O tamanho da amostra é pequeno, mas nossos achados confirmam a alta frequência da neoplasia da tireoide e hiperparatireroidismo neste grupo de pacientes. Arq Bras Endocrinol Metab. 2013;57(8):612-6 Descritores

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“…[4][5][6] Patients with acromegaly, a disease characterized by abnormally high levels of GH secretion, are at an elevated risk for colorectal cancer. [7][8][9] GH is the main determinant of circulating levels of IGF-I and its main binding protein, IGFBP-3. 1 The GH1 gene is polymorphic and a substitution polymorphism (T1663A) is considered to be associated with GH production.…”

Section: Introductionmentioning

confidence: 99%

Relationship between growth hormone 1 genetic polymorphism and susceptibility to colorectal cancer

Gao

Gong

et al. 2010

J Hum Genet

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The aim of this study was to evaluate the relationship between smoking, alcohol drinking and genetic polymorphism of the growth hormone 1 gene (GH1) T1663A with reference to colorectal cancer. We conducted a case-control study with 315 cases of colorectal cancer and 438 population-based controls in the Jiangsu Province, China. GH1 T1663A genotypes were identified using PCR-RFLP (restriction fragment length polymorphism) methods. Information on smoking and drinking was collected using a questionnaire. Odds ratios (ORs) were estimated with an unconditional logistic model. The distribution of T/T and A/A genotypes was significantly different between controls and cases (v 2 MH ¼3.877, P¼0.049). Compared with the GH1 T/T genotype, the A/A genotype was at a decreased risk of developing colorectal cancer (sex-, age-, body mass index-, smokingand alcohol drinking-adjusted OR¼0.56, 95% confidence interval: 0.34-0.90). Smoking was not associated with the risk of colorectal cancer, whereas alcohol drinking was associated with an increased risk of colorectal cancer. Among nonsmokers or nondrinkers, individuals who had the GH1 A/A genotype were at a decreased risk of developing colorectal cancer compared with individuals who had the GH1 T allele. These results show that the GH1 T1663A A/A genotype can decrease the risk for colorectal cancer.

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Acromegaly, colonic polyps and carcinoma

Abstract: Patients with acromegaly have an increased risk of developing colorectal cancer and a significantly higher prevalence of tubulovillous adenomas compared with normal subjects. Routine surveillance colonoscopy is indicated in this group of patients.

Cited by 198 publications

References 21 publications

Repeated colonoscopic screening of patients with acromegaly: 15-year experience identifies those at risk of new colonic neoplasia and allows for effective screening guidelines

Repeated colonoscopic screening of patients with acromegaly: 15-year experience identifies those at risk of new colonic neoplasia and allows for effective screening guidelines

Frequency of various types of neoplasia in a group of acromegalic patients

Relationship between growth hormone 1 genetic polymorphism and susceptibility to colorectal cancer

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