Cancer risks in patients treated with growth hormone in childhood: The SAGhE European cohort study

Anthony J. Swerdlow, Rosie Cooke, Dominique Beckers, Birgit Borgström, Gary Butler, Jean Claude Carel, Stefano Cianfarani, Peter Clayton, Joë L. Coste, Annalisa Deodati, Emmanuel Ecosse, Ruth Gausche, Claudio Giacomozzi, Anita C.S. Hokken-Koelega, Aysha J. Khan, Wieland Kiess, Claudia E. Kuehni, Primus E. Mullis, Roland Pfaffle, Lars SävendahlGrit Sommer, Muriel Thomas, Anders Tidblad, Sally Tollerfield, Liesbet Van Eycken, Gladys R.J. Zandwijken

Research output: Contribution to journalArticlepeer-review

Abstract

Context: Growth hormone (GH) is prescribed for an increasing range of indications, but there has been concern that it might raise cancer risk. Published data are limited. Objective: To examine cancer risks in relation to GH treatment. Design: Cohort study. Setting: Population-based. Patients: Cohort of 23,984 patients treated with recombinant human GH (r-hGH) in eight European countries since this treatment was first used in 1984. Cancer expectations from country-specific national population statistics. Main Outcome Measures: Cancer incidence and cancer mortality. Results: Incidence and mortality risks in the cohort were raised for several cancer sites, largely consequent on second primary malignancies in patients given r-hGH after cancer treatment. There was no clear raised risk in patients with growth failurewithout othermajor disease.Only for bone and bladder cancers was incidence significantly raised in GH-treated patients without previous cancer. Cancer risk was unrelated to duration or cumulative dose of r-hGHtreatment, but for patients treated after previous cancer, cancer mortality risk increased significantly with increasing daily r-hGH dose (P trend < 0.001). Hodgkin lymphoma (HL) incidence increased significantly with longer follow-up (P trend = 0.001 for patients overall and 0.002 for patients without previous cancer). Conclusions: Our results do not generally support a carcinogenic effect of r-hGH, but the unexplained trend in cancer mortality risk in relation to GH dose in patients with previous cancer, and the indication of possible effects on bone cancer, bladder cancer, and HL risks, need further investigation.

Original languageEnglish
Pages (from-to)1661-1672
Number of pages12
JournalJournal of Clinical Endocrinology and Metabolism
Volume102
Issue number5
DOIs
Publication statusPublished - May 1 2017

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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