Assessment of the frequency and risk factors for colorectal cancer in acromegaly.

Endocrine

Endocrine Unit and Neuroendocrinology Research Center, Medical School, and Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

Published: November 2024

AI Article Synopsis

  • Acromegaly is linked to an uncertain increased risk for colorectal cancer (CRC), prompting this study to evaluate the prevalence of colonic adenomatous polyps and CRC in acromegaly patients during colonoscopies.
  • The study involved 123 patients and found that the majority had non-neoplastic findings at their first colonoscopy, with a small percentage developing CRC over time; risk factors like age and smoking were significantly associated with neoplasia.
  • Findings indicate that older age (specifically over 50) and smoking elevate the risk of colonic lesions, suggesting that the recommended screening age for CRC in those with acromegaly may need to be reconsidered.

Article Abstract

Introduction: Acromegaly is associated with a possible increased risk of neoplasias, like colorectal cancer (CRC), although magnitude of this risk is unclear.

Objectives: Evaluate frequency of colonic adenomatous polyps and CRC in patients with acromegaly at first and subsequent colonoscopies; correlate risk factors of CRC and disease activity of acromegaly with colonoscopy findings and analyze relationship of acromegaly as a risk factor for CRC and the best period for screening this neoplasia.

Methods: Patients ≥18 years-old with acromegaly were included. A questionnaire involving characteristics of follow-up of acromegaly and risk factors of CRC was created. Biochemical and colonoscopic data were collected through medical records. Only full-length colonoscopies with satisfactory colonic preparation were included.

Results: 123 patients (77 women) were included (mean age at diagnosis of 43.1 years and mean follow-up of 13.7 years). In baseline colonoscopy, 80.5% had non-neoplastic findings, 14.6% non-advanced adenomas, 3.3% advanced adenomas and 1.6% CRC. At end of the study, 3 (2.4%) patients were diagnosed with CRC. No patient under 50 years had a neoplastic lesion on colonoscopy. We observed a positive statistically significant relationship between smoking (p = 0.026), age at diagnosis of acromegaly (p < 0.001), age at baseline colonoscopy (p = 0.002), and risk of adenomas and/or CRC at initial colonoscopy.

Conclusions: Smoking and advanced age were positively related to a higher risk of developing premalignant/malignant colonic lesions. Age ( > 50 years) was the most robust variable. Our data suggest that screening age for CRC in acromegaly should be reviewed.

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Source
http://dx.doi.org/10.1007/s12020-024-04099-2DOI Listing

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