title: Incidence of a second tumor in hypopituitary patients operated for pituitary tumors.
abstract: Recently, an association between increased blood levels of insulin-like growth factor I (IGF-I) and increased risks of prostate, breast, lung, and colorectal cancers has been suggested. As today adults with GH deficiency are subjected to GH substitution, there is a pressing need for baseline tumor incidence data. The aim of the study was to assess the risk for a second tumor in a cohort of 328 patients with hypopituitarism treated for a pituitary tumor from 1958--1992. The patients were receiving conventional hormone treatment, but without GH substitution. The overall tumor incidence [standardized incidence ratio (SIR)] was lower than expected (0.85), but the 95% confidence interval (CI) did not exclude unity (0.59--1.21). Only two prostate cancers occurred (SIR, 0.34; 95% CI, 0.04--1.24). Two brain tumors (SIR, 1.96; 95% CI, 0.24--7.08) and two endocrine tumors (part of multiple endocrine neoplasm syndromes; SIR, 4.00; 95% CI, 0.48--14.5) had occurred. When excluding brain and endocrine tumors, the overall SIR decreased to 0.77, but did still not differ significantly from unity (0.52--1.13). Thus, a tendency for a decreased overall tumor risk, although not statistically significant, was noted, especially when excluding brain and endocrine tumors. This tendency was more emphasized for prostate cancer, but low numbers hamper a firm conclusion. These results may serve as a baseline for tumor risk among adult patients with pituitary insufficiency supplemented with GH.
authors.affiliation: Department of Internal Medicine, Division of Diabetology and Endocrinology, University Hospital, S-221 85 Lund, Sweden. eva-marie.erfurth@med.lu.se
authors.forename: E M
authors.initials: EM
authors.lastname: Erfurth
authors.forename: B
authors.initials: B
authors.lastname: Bülow
authors.forename: Z
authors.initials: Z
authors.lastname: Mikoczy
authors.forename: L
authors.initials: L
authors.lastname: Hagmar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology* / Q000601:surgery; D015994:Incidence; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D010911:Pituitary Neoplasms / Q000145:classification / Q000532:radiotherapy / Q000601:surgery*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors