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
Meta-Analysis
. 2023 Nov 30;18(11):e0285335.
doi: 10.1371/journal.pone.0285335. eCollection 2023.

Risk of cancer in acromegaly patients: An updated meta-analysis and systematic review

Zhehao Xiao  1 , Pingping Xiao  2 , Yong Wang  1 , Chen Fang  1 , Yong Li  1
Affiliations
Meta-Analysis

Risk of cancer in acromegaly patients: An updated meta-analysis and systematic review

Zhehao Xiao et al. PLoS One. .

Abstract

The incidence of cancer in acromegaly patients may be higher than that in the general population, although this has not been fully elucidated yet. This study analyzed the risk of various important types of cancer in acromegaly patients. The study was registered in INPLASY (registration number: INPLASY202340037). The PubMed, Web of Science, and EMBASE databases were searched for studies based on strict inclusion and exclusion criteria, from the time of database inception up to June 30, 2022. All observational studies of acromegaly patients with cancer were included, without language restrictions. We used the Newcastle-Ottawa scale (NOS) checklist to assess the quality of evidence. A meta-analysis revealed the relationship between acromegaly and cancer using the standardized incidence rates (SIRs) and 95% confidence intervals (CIs) retrieved from the included studies. Nineteen studies were included and analyzed. The overall incidence of cancer (SIR = 1.45, 95%CI = 1.20-1.75), as well as that of thyroid (SIR = 6.96, 95%CI = 2.51-19.33), colorectal and anal (SIR = 1.95, 95%CI = 1.32-2.87), brain and central nervous system (SIR = 6.14, 95%CI = 2.73-13.84), gastric (SIR = 3.09, 95%CI = 1.47-6.50), urinary (SIR = 2.66, 95%CI = 1.88-3.76), hematological (SIR = 1.89, 95%CI = 1.17-3.06), pancreatic and small intestine (SIR = 2.59, 95%CI = 1.58-4.24), and connective tissue (SIR = 3.15, 95%CI = 1.18-8.36) cancers, was higher among patients with acromegaly than among the general population. No association between acromegaly and hepatobiliary, respiratory, reproductive, skin, breast, or prostate cancer was observed. This study demonstrated that acromegaly patients have a modestly increased chance of cancer as compared to the general population. Risk factors for cancer need to be further explored to monitor patients with acromegaly at a high risk for cancer more carefully.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study selection flowchart.
Fig 2
Fig 2. Pooled SIR of overall cancer in patients with acromegaly.
Fig 3
Fig 3. Pooled SIRs of various significant cancers in patients with acromegaly.
Fig 4
Fig 4. Pooled SIRs of cancer in patients with acromegaly according to sex.
See this image and copyright information in PMC

References

    1. Colao A, Grasso LFS, Giustina A, Melmed S, Chanson P, Pereira AM, et al.. Acromegaly. Nat Rev Dis Primers. 2019;5(1):20. Epub 2019/03/23. doi: 10.1038/s41572-019-0071-6 . - DOI - PubMed
    1. Boguszewski CL, Ayuk J. MANAGEMENT OF ENDOCRINE DISEASE: Acromegaly and cancer: an old debate revisited. Eur J Endocrinol. 2016;175(4):R147–56. Epub 2016/04/20. doi: 10.1530/eje-16-0178 . - DOI - PubMed
    1. Boguszewski CL, Boguszewski M. Growth Hormone’s Links to Cancer. Endocr Rev. 2019;40(2):558–74. Epub 2018/12/01. doi: 10.1210/er.2018-00166 . - DOI - PubMed
    1. Park KH, Lee EJ, Seo GH, Ku CR. Risk for Acromegaly-related Comorbidities by Sex in Korean Acromegaly. J Clin Endocrinol Metab. 2020;105(4). Epub 2020/01/07. doi: 10.1210/clinem/dgz317 . - DOI - PubMed
    1. Esposito D, Ragnarsson O, Johannsson G, Olsson DS. Incidence of Benign and Malignant Tumors in Patients With Acromegaly Is Increased: A Nationwide Population-based Study. J Clin Endocrinol Metab. 2021;106(12):3487–96. Epub 2021/08/04. doi: 10.1210/clinem/dgab560 . - DOI - PubMed