Risk of colorectal neoplasm in patients with acromegaly: a meta-analysis.
OBJECTIVE
To examine the risk of colorectal neoplasm in acromegalic patients by meta-analyzing all relevant controlled studies.


METHODS
Extensive English language medical literature searches for human studies, up to December 2007, were performed using suitable keywords. Pooled estimates [odds ratio (OR) with 95% confidence intervals (CI)] were obtained using either the fixed or random-effects model as appropriate. Heterogeneity between studies was evaluated with the Cochran Q test whereas the likelihood of publication bias was assessed by constructing funnel plots. Their symmetry was estimated by the adjusted rank correlation test.


RESULTS
For hyperplastic polyps the pooled ORs with 95% CI were 3.557 (2.587-4.891) by fixed effects model and 3.703 (2.565-5.347) by random effects model. The Z test values for overall effect were 7.81 and 6.984, respectively (P < 0.0001). For colon adenomas the pooled ORs with 95% CI were 2.486 (1.908-3.238) (fixed effects model) and 2.537 (1.914-3.364) (random effects model). The Z test values were 6.747 and 6.472, respectively (P < 0.0001). For colon cancer the pooled OR with 95% CI was identical for both fixed and random effects model (OR, 4.351; 95% CI, 1.533-12.354; Z = 2.762, P = 0.006]. There was no significant heterogeneity and no publication bias in all the above meta-analyses.


CONCLUSIONS
Acromegaly is associated with an increased risk of colorectal neoplasm.
Gastroenterology Clinic, Henry Dunant Hospital, Athens, Greece. sakkor@otenet.gr
Theodoros
T
Rokkas
Dimitrios
D
Pistiolas
Panos
P
Sechopoulos
Georgios
G
Margantinis
Georgios
G
Koukoulis
D000172:Acromegaly / Q000150:complications*; D000236:Adenoma / Q000453:epidemiology*; D003111:Colonic Polyps / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D006801:Humans; D012307:Risk Factors