Acromegaly is associated with increased cancer risk: A survey in Italy

Massimo Terzolo, Giuseppe Reimondo, Paola Berchialla, Emanuele Ferrante, Elena Malchiodi, Laura De Marinis, Rosario Pivonello, Silvia Grottoli, Marco Losa, Salvatore Cannavo, Diego Ferone, Marcella Montini, Marta Bondanelli, Ernesto De Menis, Chiara Martini, Efisio Puxeddu, Antonino Velardo, Alessandro Peri, Marco Faustini-Fustini, Patrizia TitaFrancesca Pigliaru, Giulia Peraga, Giorgio Borretta, Carla Scaroni, Nicoletta Bazzoni, Antonio Bianchi, Alessandro Berton, Andreea Liliana Serban, Roberto Baldelli, Letizia Maria Fatti, Annamaria Colao, Maura Arosio, G. Lombardi, F. Trimarchi, E. C. Degli Uberti, M. R. Ambrosio, G. Pagani, R. Attanasio, E. Kara, F. Mantero, F. Ceccato, P. Mortini, P. Razzore, G. Angeletti, D. Della Torre, S. Mariotti, M. Appetecchia, E. Nazzari, F. Cavagnini, L. Persani, Italian Study Group of Acromegaly

Research output: Contribution to journalReview article

Abstract

It is debated if acromegalic patients have an increased risk to develop malignancies. The aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in acromegaly on a large series of acromegalic patients managed in the somatostatin analogs era. It was evaluated the incidence of cancer in an Italian nationwide multicenter cohort study of 1512 acromegalic patients, 624 men and 888 women, mean age at diagnosis 45 ± 13 years, followed up for a mean of 10 years (12573 person-years) in respect to the general Italian population. Cancer was diagnosed in 124 patients, 72 women and 52 men. The SIRs for all cancers was significantly increased compared to the general Italian population (expected: 88, SIR 1.41; 95% CI, 1.18-1.68, P < 0.001). In the whole series, we found a significantly increased incidence of colorectal cancer (SIR 1.67; 95% CI, 1.07-2.58, P = 0.022), kidney cancer (SIR 2.87; 95% CI, 1.55-5.34, P < 0.001) and thyroid cancer (SIR 3.99; 95% CI, 2.32-6.87, P < 0.001). The exclusion of 11 cancers occurring before diagnosis of acromegaly (all in women) did not change remarkably the study outcome. In multivariate analysis, the factors significantly associated with an increased risk of malignancy were age and family history of cancer, with a non-significant trend for the estimated duration of acromegaly before diagnosis. In conclusion, we found evidence that acromegaly in Italy is associated with a moderate increase in cancer risk.

Original languageEnglish
Pages (from-to)495-504
Number of pages10
JournalEndocrine-Related Cancer
Volume24
Issue number9
DOIs
Publication statusPublished - Sep 1 2017

Fingerprint

Acromegaly
Italy
Incidence
Neoplasms
Surveys and Questionnaires
Kidney Neoplasms
Somatostatin
Thyroid Neoplasms
Population
Multicenter Studies
Colorectal Neoplasms
Cohort Studies
Multivariate Analysis
Outcome Assessment (Health Care)

Keywords

  • Acromegaly cancer
  • Gh IGF1

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Oncology
  • Endocrinology
  • Cancer Research

Cite this

Terzolo, M., Reimondo, G., Berchialla, P., Ferrante, E., Malchiodi, E., De Marinis, L., ... Italian Study Group of Acromegaly (2017). Acromegaly is associated with increased cancer risk: A survey in Italy. Endocrine-Related Cancer, 24(9), 495-504. https://doi.org/10.1530/ERC-16-0553

Acromegaly is associated with increased cancer risk : A survey in Italy. / Terzolo, Massimo; Reimondo, Giuseppe; Berchialla, Paola; Ferrante, Emanuele; Malchiodi, Elena; De Marinis, Laura; Pivonello, Rosario; Grottoli, Silvia; Losa, Marco; Cannavo, Salvatore; Ferone, Diego; Montini, Marcella; Bondanelli, Marta; De Menis, Ernesto; Martini, Chiara; Puxeddu, Efisio; Velardo, Antonino; Peri, Alessandro; Faustini-Fustini, Marco; Tita, Patrizia; Pigliaru, Francesca; Peraga, Giulia; Borretta, Giorgio; Scaroni, Carla; Bazzoni, Nicoletta; Bianchi, Antonio; Berton, Alessandro; Serban, Andreea Liliana; Baldelli, Roberto; Fatti, Letizia Maria; Colao, Annamaria; Arosio, Maura; Lombardi, G.; Trimarchi, F.; Degli Uberti, E. C.; Ambrosio, M. R.; Pagani, G.; Attanasio, R.; Kara, E.; Mantero, F.; Ceccato, F.; Mortini, P.; Razzore, P.; Angeletti, G.; Della Torre, D.; Mariotti, S.; Appetecchia, M.; Nazzari, E.; Cavagnini, F.; Persani, L.; Italian Study Group of Acromegaly.

In: Endocrine-Related Cancer, Vol. 24, No. 9, 01.09.2017, p. 495-504.

Research output: Contribution to journalReview article

Terzolo, M, Reimondo, G, Berchialla, P, Ferrante, E, Malchiodi, E, De Marinis, L, Pivonello, R, Grottoli, S, Losa, M, Cannavo, S, Ferone, D, Montini, M, Bondanelli, M, De Menis, E, Martini, C, Puxeddu, E, Velardo, A, Peri, A, Faustini-Fustini, M, Tita, P, Pigliaru, F, Peraga, G, Borretta, G, Scaroni, C, Bazzoni, N, Bianchi, A, Berton, A, Serban, AL, Baldelli, R, Fatti, LM, Colao, A, Arosio, M, Lombardi, G, Trimarchi, F, Degli Uberti, EC, Ambrosio, MR, Pagani, G, Attanasio, R, Kara, E, Mantero, F, Ceccato, F, Mortini, P, Razzore, P, Angeletti, G, Della Torre, D, Mariotti, S, Appetecchia, M, Nazzari, E, Cavagnini, F, Persani, L & Italian Study Group of Acromegaly 2017, 'Acromegaly is associated with increased cancer risk: A survey in Italy', Endocrine-Related Cancer, vol. 24, no. 9, pp. 495-504. https://doi.org/10.1530/ERC-16-0553
Terzolo M, Reimondo G, Berchialla P, Ferrante E, Malchiodi E, De Marinis L et al. Acromegaly is associated with increased cancer risk: A survey in Italy. Endocrine-Related Cancer. 2017 Sep 1;24(9):495-504. https://doi.org/10.1530/ERC-16-0553
Terzolo, Massimo ; Reimondo, Giuseppe ; Berchialla, Paola ; Ferrante, Emanuele ; Malchiodi, Elena ; De Marinis, Laura ; Pivonello, Rosario ; Grottoli, Silvia ; Losa, Marco ; Cannavo, Salvatore ; Ferone, Diego ; Montini, Marcella ; Bondanelli, Marta ; De Menis, Ernesto ; Martini, Chiara ; Puxeddu, Efisio ; Velardo, Antonino ; Peri, Alessandro ; Faustini-Fustini, Marco ; Tita, Patrizia ; Pigliaru, Francesca ; Peraga, Giulia ; Borretta, Giorgio ; Scaroni, Carla ; Bazzoni, Nicoletta ; Bianchi, Antonio ; Berton, Alessandro ; Serban, Andreea Liliana ; Baldelli, Roberto ; Fatti, Letizia Maria ; Colao, Annamaria ; Arosio, Maura ; Lombardi, G. ; Trimarchi, F. ; Degli Uberti, E. C. ; Ambrosio, M. R. ; Pagani, G. ; Attanasio, R. ; Kara, E. ; Mantero, F. ; Ceccato, F. ; Mortini, P. ; Razzore, P. ; Angeletti, G. ; Della Torre, D. ; Mariotti, S. ; Appetecchia, M. ; Nazzari, E. ; Cavagnini, F. ; Persani, L. ; Italian Study Group of Acromegaly. / Acromegaly is associated with increased cancer risk : A survey in Italy. In: Endocrine-Related Cancer. 2017 ; Vol. 24, No. 9. pp. 495-504.
@article{3e7085586db24fc4a2dad508f702924e,
title = "Acromegaly is associated with increased cancer risk: A survey in Italy",
abstract = "It is debated if acromegalic patients have an increased risk to develop malignancies. The aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in acromegaly on a large series of acromegalic patients managed in the somatostatin analogs era. It was evaluated the incidence of cancer in an Italian nationwide multicenter cohort study of 1512 acromegalic patients, 624 men and 888 women, mean age at diagnosis 45 ± 13 years, followed up for a mean of 10 years (12573 person-years) in respect to the general Italian population. Cancer was diagnosed in 124 patients, 72 women and 52 men. The SIRs for all cancers was significantly increased compared to the general Italian population (expected: 88, SIR 1.41; 95{\%} CI, 1.18-1.68, P < 0.001). In the whole series, we found a significantly increased incidence of colorectal cancer (SIR 1.67; 95{\%} CI, 1.07-2.58, P = 0.022), kidney cancer (SIR 2.87; 95{\%} CI, 1.55-5.34, P < 0.001) and thyroid cancer (SIR 3.99; 95{\%} CI, 2.32-6.87, P < 0.001). The exclusion of 11 cancers occurring before diagnosis of acromegaly (all in women) did not change remarkably the study outcome. In multivariate analysis, the factors significantly associated with an increased risk of malignancy were age and family history of cancer, with a non-significant trend for the estimated duration of acromegaly before diagnosis. In conclusion, we found evidence that acromegaly in Italy is associated with a moderate increase in cancer risk.",
keywords = "Acromegaly cancer, Gh IGF1",
author = "Massimo Terzolo and Giuseppe Reimondo and Paola Berchialla and Emanuele Ferrante and Elena Malchiodi and {De Marinis}, Laura and Rosario Pivonello and Silvia Grottoli and Marco Losa and Salvatore Cannavo and Diego Ferone and Marcella Montini and Marta Bondanelli and {De Menis}, Ernesto and Chiara Martini and Efisio Puxeddu and Antonino Velardo and Alessandro Peri and Marco Faustini-Fustini and Patrizia Tita and Francesca Pigliaru and Giulia Peraga and Giorgio Borretta and Carla Scaroni and Nicoletta Bazzoni and Antonio Bianchi and Alessandro Berton and Serban, {Andreea Liliana} and Roberto Baldelli and Fatti, {Letizia Maria} and Annamaria Colao and Maura Arosio and G. Lombardi and F. Trimarchi and {Degli Uberti}, {E. C.} and Ambrosio, {M. R.} and G. Pagani and R. Attanasio and E. Kara and F. Mantero and F. Ceccato and P. Mortini and P. Razzore and G. Angeletti and {Della Torre}, D. and S. Mariotti and M. Appetecchia and E. Nazzari and F. Cavagnini and L. Persani and {Italian Study Group of Acromegaly}",
year = "2017",
month = "9",
day = "1",
doi = "10.1530/ERC-16-0553",
language = "English",
volume = "24",
pages = "495--504",
journal = "Endocrine-Related Cancer",
issn = "1351-0088",
publisher = "BioScientifica Ltd.",
number = "9",

}

TY - JOUR

T1 - Acromegaly is associated with increased cancer risk

T2 - A survey in Italy

AU - Terzolo, Massimo

AU - Reimondo, Giuseppe

AU - Berchialla, Paola

AU - Ferrante, Emanuele

AU - Malchiodi, Elena

AU - De Marinis, Laura

AU - Pivonello, Rosario

AU - Grottoli, Silvia

AU - Losa, Marco

AU - Cannavo, Salvatore

AU - Ferone, Diego

AU - Montini, Marcella

AU - Bondanelli, Marta

AU - De Menis, Ernesto

AU - Martini, Chiara

AU - Puxeddu, Efisio

AU - Velardo, Antonino

AU - Peri, Alessandro

AU - Faustini-Fustini, Marco

AU - Tita, Patrizia

AU - Pigliaru, Francesca

AU - Peraga, Giulia

AU - Borretta, Giorgio

AU - Scaroni, Carla

AU - Bazzoni, Nicoletta

AU - Bianchi, Antonio

AU - Berton, Alessandro

AU - Serban, Andreea Liliana

AU - Baldelli, Roberto

AU - Fatti, Letizia Maria

AU - Colao, Annamaria

AU - Arosio, Maura

AU - Lombardi, G.

AU - Trimarchi, F.

AU - Degli Uberti, E. C.

AU - Ambrosio, M. R.

AU - Pagani, G.

AU - Attanasio, R.

AU - Kara, E.

AU - Mantero, F.

AU - Ceccato, F.

AU - Mortini, P.

AU - Razzore, P.

AU - Angeletti, G.

AU - Della Torre, D.

AU - Mariotti, S.

AU - Appetecchia, M.

AU - Nazzari, E.

AU - Cavagnini, F.

AU - Persani, L.

AU - Italian Study Group of Acromegaly

PY - 2017/9/1

Y1 - 2017/9/1

N2 - It is debated if acromegalic patients have an increased risk to develop malignancies. The aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in acromegaly on a large series of acromegalic patients managed in the somatostatin analogs era. It was evaluated the incidence of cancer in an Italian nationwide multicenter cohort study of 1512 acromegalic patients, 624 men and 888 women, mean age at diagnosis 45 ± 13 years, followed up for a mean of 10 years (12573 person-years) in respect to the general Italian population. Cancer was diagnosed in 124 patients, 72 women and 52 men. The SIRs for all cancers was significantly increased compared to the general Italian population (expected: 88, SIR 1.41; 95% CI, 1.18-1.68, P < 0.001). In the whole series, we found a significantly increased incidence of colorectal cancer (SIR 1.67; 95% CI, 1.07-2.58, P = 0.022), kidney cancer (SIR 2.87; 95% CI, 1.55-5.34, P < 0.001) and thyroid cancer (SIR 3.99; 95% CI, 2.32-6.87, P < 0.001). The exclusion of 11 cancers occurring before diagnosis of acromegaly (all in women) did not change remarkably the study outcome. In multivariate analysis, the factors significantly associated with an increased risk of malignancy were age and family history of cancer, with a non-significant trend for the estimated duration of acromegaly before diagnosis. In conclusion, we found evidence that acromegaly in Italy is associated with a moderate increase in cancer risk.

AB - It is debated if acromegalic patients have an increased risk to develop malignancies. The aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in acromegaly on a large series of acromegalic patients managed in the somatostatin analogs era. It was evaluated the incidence of cancer in an Italian nationwide multicenter cohort study of 1512 acromegalic patients, 624 men and 888 women, mean age at diagnosis 45 ± 13 years, followed up for a mean of 10 years (12573 person-years) in respect to the general Italian population. Cancer was diagnosed in 124 patients, 72 women and 52 men. The SIRs for all cancers was significantly increased compared to the general Italian population (expected: 88, SIR 1.41; 95% CI, 1.18-1.68, P < 0.001). In the whole series, we found a significantly increased incidence of colorectal cancer (SIR 1.67; 95% CI, 1.07-2.58, P = 0.022), kidney cancer (SIR 2.87; 95% CI, 1.55-5.34, P < 0.001) and thyroid cancer (SIR 3.99; 95% CI, 2.32-6.87, P < 0.001). The exclusion of 11 cancers occurring before diagnosis of acromegaly (all in women) did not change remarkably the study outcome. In multivariate analysis, the factors significantly associated with an increased risk of malignancy were age and family history of cancer, with a non-significant trend for the estimated duration of acromegaly before diagnosis. In conclusion, we found evidence that acromegaly in Italy is associated with a moderate increase in cancer risk.

KW - Acromegaly cancer

KW - Gh IGF1

UR - http://www.scopus.com/inward/record.url?scp=85041211091&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85041211091&partnerID=8YFLogxK

U2 - 10.1530/ERC-16-0553

DO - 10.1530/ERC-16-0553

M3 - Review article

AN - SCOPUS:85041211091

VL - 24

SP - 495

EP - 504

JO - Endocrine-Related Cancer

JF - Endocrine-Related Cancer

SN - 1351-0088

IS - 9

ER -