Cancer detection in long-term follow-up of patients with acromegaly
S. Vallette, C. Beauregard, N. Aris-Jilwan, H. Beauregard & O. Serri
Objective: To evaluate the prevalence of cancer in patients with acromegaly followed in our institution.
Design and Patients: Retrospective analysis of clinical data from our Quebec pituitary tumor registry. A total of 107 patients with acromegaly (49% females) followed at the Centre de lUniversité de Montréal (CHUM) from 1980 to 2011 for a median of 7 years (Q1Q3: 312).
Results: Thirteen cancers were detected in 11 (10.3%) patients over a period of 12 years. Thyroid (papillary) carcinoma was found in four patients, urologic cancer in three, two different skin cancers (basocellular carcinoma and melanoma) in the same patient, breast cancer in one, ovary adenocarcinoma in one, oesophageal cancer in one and acute leukemia in one patient. Cancer was more common in male patients (73%). Cancer was diagnosed prior to, simultaneously and after diagnosis of acromegaly in four, one and eight cases, respectively. Age of patients at cancer diagnosis was 59 years (5662). Age of patients at diagnosis of acromegaly was significantly higher in patients with cancer compared to patients without (56 (4562) vs 42 (3352) years, P=0.02). Time delay from reported acromegaly symptoms onset to diagnosis seemed to be longer, as well as diabetes seemed to be more frequent in acromegalic patients with cancer than in those without, but these differences did not reach statistical significance. There were no significant differences between patients with cancer and those without for initial GH and IGF1 levels, follow-up duration, as well as control of the disease defined by IGF1 normalization.
Conclusion: In our series, cancer seemed to be more frequent in aged patients with acromegaly. Thyroid cancer was the most common cancer associated with acromegaly. Therefore, routine medical follow-up of patients with acromegaly should include a careful assessment for thyroid nodules and cancers.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This work was supported, however funding details unavailable.