Cancer risk in a large acromegaly cohort: a standardized incidence ratio analysis
Authors' conclusion
In this large single-center Turkish acromegaly cohort, the overall SIR (5.48) exceeded the pooled population-based estimate of 1.45. The non-thyroid SIR remained significant across all sensitivity analyses (range 2.22-3.45), indicating multi-site predisposition beyond surveillance bias. Cumulative IGF-1 exposure independently predicted cancer, supporting sustained hormonal excess as a driver of oncogenesis. These findings support systematic thyroid screening and heightened vigilance for non-thyroid malignancies in tertiary-managed acromegaly.
Study context
- Population
- Acromegaly patients followed at a single tertiary center in Turkey (1980–2023)
- Participants
- 393 patients
- Exposure
- Acromegaly cohort vs Turkish national cancer rates
- Outcome
- Overall and site-specific cancer risk (SIR vs Turkish national cancer rates)
- Follow-up
- Median 9 years
Methodological detailssingle-centre, standardized incidence ratio analysis
- Single-centre
- Standardized incidence ratio analysis
Main finding
As reported in the abstract
- Developed cancer
- 64 (16.3%)
- Overall cancer SIR
- 5.48 (95% CI 4.15-7.10)
- Thyroid cancer SIR (p < 0.001)
- 46.25
- Renal/urinary cancer SIR (p < 0.001)
- 7.38
- Breast cancer SIR (p = 0.006)
- 3.75
Observational data: associations, not effects.
Further findings
Non-thyroid cancer SIR
- Non-thyroid SIR (1.86-3.94, p < 0.001)
- 2.76
- Non-thyroid SIR across graded landmarks (all p < 0.001)
- range 2.42-2.53
- Stable across graded landmarks and other sensitivity analyses
Cumulative IGF-1 exposure (TWAvg × ULN), cancer vs no cancer
- TWAvg IGF-1 higher in cancer group (×ULN; p = 0.002)
- 1.26 vs. 0.97
- TWAvg IGF-1 independently predicted cancer, OR
- 1.80 (95% CI 1.21-2.69; p = 0.004)
- Multivariable logistic regression
Original publication
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