The association between acromegaly and cancer had been assessed mainly in population studies with inconsistent results. The objective of this study was to investigate the risk of cancer in a large cohort of patients with acromegaly compared with matched controls. The comprehensive computerized database of the largest healthcare provider organization in Israel was searched for patients diagnosed with acromegaly in 2000-2021. All diagnoses were qualitatively validated. Patients were individually matched 1:5 with a control group for age, sex, and socioeconomic status. Clinical and outcome data were collected from the medical files. The final cohort consisted of 470 patients (54% male) with acromegaly and 2330 control subjects. Mean age at diagnosis was 53 years, and mean duration of follow-up after diagnosis was 10.4 years. The prevalence of solid malignancies was 21.3% in the acromegaly group and 14.8% in the control group (OR 1.6, 95% CI 1.2-2.0). Patients with acromegaly had a higher rate of thyroid cancer (2.8% vs 0.6%; OR 5.1, CI 2.3-11.0) and a tendency for a higher risk of colorectal cancer (3.6% vs 2.8%; OR 1.3, CI 0.7-2.2), prostate cancer (2.8% vs 1.7%; OR 1.6, CI 0.8-3.1), and renal cancer (1.5% vs 0.8%; OR 1.8, CI 0.8-4.4), but not hematological malignancies. They also had a higher mortality rate (21.3% vs 15.7%; OR 1.5, CI 1.1-1.9). In conclusion, the higher prevalence of malignant solid tumors in patients with acromegaly compared with control subjects suggests that periodic screening for early detection of solid cancers may be considered in this patient population.
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