Does acromegaly really predispose to an increased prevalence of gastrointestinal tumours?
OBJECTIVE
The few published prospective studies suggest a strong association of colonic tumours with acromegaly, but include small numbers of patients. In addition, the upper gastrointestinal tract of these patients has never been prospectively studied. The aim of the present study was to investigate the incidence of gastric and colonic tumours in a large cohort of acromegalic patients.


METHODS
Acromegalic patients consecutively admitted to an Endocrinology Department for diagnosis and follow-up, were submitted to gastroscopy and colonoscopy, to identify those harbouring gastrointestinal tumours.


METHODS
Over a 5-year period, 54 out of 61 patients (78% with active disease) received colonoscopy and 42 out of 61 gastroscopy. No patient had a past history of gastrointestinal malignancy.


METHODS
All polypoid lesions found at colonoscopy and gastroscopy were separately recorded and biopsied.


RESULTS
No case of gastrointestinal cancer or gastric polyp was discovered. Nineteen patients (35%) had 1-8 colonic polyps, including 5 (9.3%) with adenomas. When compared to patients with a normal colon, those with polyps were significantly older (44.5 +/- 14.2 vs 52.1 +/- 10.9 years, P = 0.047), but the duration of acromegaly (10.8 +/- 8.4 vs 10.9 +/- 7.1 years, P = 0.9) and the number of patients with active disease were similar in both groups.


CONCLUSIONS
Acromegalic patients do not have an increased incidence of gastric tumours. The observed significant variation in the prevalence of colonic adenomas (9-35%, P = 0.03) and cancer (0-15%, P = 0.017), between our patients and those of the published prospective studies with similar demographic characteristics, suggest that environmental and hereditary factors may be more important than the presence of acromegaly.
Ladas
S D
SD
Gastroenterology Unit-Second Department of Internal Medicine, University of Athens, Evangelismos Hospital, Greece.
Thalassinos
N C
NC
Ioannides
G
G
Raptis
S A
SA
D000172:Acromegaly / Q000150:complications*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015984:Causality; D003110:Colonic Neoplasms / Q000150:complications; D003111:Colonic Polyps / Q000150:complications; D003113:Colonoscopy; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013272:Stomach Diseases / Q000150:complications; D013274:Stomach Neoplasms / Q000150:complications