Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May 1;102(5):1661-1672.
doi: 10.1210/jc.2016-2046.

Cancer Risks in Patients Treated With Growth Hormone in Childhood: The SAGhE European Cohort Study

Anthony J Swerdlow  1   2 , Rosie Cooke  1 , Dominique Beckers  3   4 , Birgit Borgström  5 , Gary Butler  6   7 , Jean-Claude Carel  8   9 , Stefano Cianfarani  10   11 , Peter Clayton  12   13 , Joël Coste  14   15 , Annalisa Deodati  10 , Emmanuel Ecosse  14   15 , Ruth Gausche  16 , Claudio Giacomozzi  17 , Anita C S Hokken-Koelega  18   19 , Aysha J Khan  12   13 , Wieland Kiess  16 , Claudia E Kuehni  20 , Primus-E Mullis  21 , Roland Pfaffle  16 , Lars Sävendahl  11 , Grit Sommer  20 , Muriel Thomas  4 , Anders Tidblad  11 , Sally Tollerfield  6 , Liesbet Van Eycken  22 , Gladys R J Zandwijken  18   19
Affiliations

Cancer Risks in Patients Treated With Growth Hormone in Childhood: The SAGhE European Cohort Study

Anthony J Swerdlow et al. J Clin Endocrinol Metab. .

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 failure without other major 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-hGH treatment, 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.

PubMed Disclaimer

Conflict of interest statement

Disclosure summary: PC is a consultant for MerckSerono. LS is a member of the NordiNet International Study Committee (Novo Nordisk) and recipient of investigator-initiated independent research awards from MerckSerono (GGI award), NovoNordisk and Pfizer, and lecture honoraria from Ferring, Novo Nordisk, Pfizer, and Merck Serono. J-CC is an investigator in clinical trials using GH sponsored by Pfizer and by Lilly and in post-marketing studies using several brands of GH, support for travel to international meetings from several GH manufacturers. SC has received lecture fees from Ipsen, Merck-Serono, Novo Nordisk and Pfizer, research grants from Merck Serono, Eli Lilly and Pfizer, support for travel to international meetings from several GH manufacturers and is member of PRISM advisory board (Ipsen). WK is a member of the Novo Nordisk Advisory Board on GH treatment, and has received lecture and consultancy honoraria from Pfizer, Ipsen and Sandoz. AT has received lecture fees from Pfizer. All other authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Numbers of patients recruited, excluded, and analysed, SAGhE cohort
See this image and copyright information in PMC

References

    1. Swerdlow AJ. Does growth hormone therapy increase the risk of cancer? Nat Clin Pract Endocrinol Metab. 2006 Oct;2(10):530–1. - PubMed
    1. Clayton PE, Banerjee I, Murray PG, Renehan AG. Growth hormone, the insulin-like growth factor axis, insulin and cancer risk. Nat Rev Endocrinol. 2011 Jan;7(1):11–24. - PubMed
    1. Orme SM, McNally RJ, Cartwright RA, Belchetz PE. Mortality and cancer incidence in acromegaly: a retrospective cohort study. United Kingdom Acromegaly Study Group. J Clin Endocrinol Metab. 1998 Aug;83(8):2730–4. - PubMed
    1. Baris D, Gridley G, Ron E, et al. Acromegaly and cancer risk: a cohort study in Sweden and Denmark. Cancer Causes Control. 2002 Jun;13(5):395–400. - PubMed
    1. Nishi Y, Tanaka T, Takano K, et al. Recent status in the occurrence of leukemia in growth hormone-treated patients in Japan. GH Treatment Study Committee of the Foundation for Growth Science, Japan. J Clin Endocrinol Metab. 1999 Jun;84(6):1961–5. - PubMed

Publication types

MeSH terms