title: The role of colonoscopic screening in acromegaly revisited: review of current literature and practice guidelines.
abstract: BACKGROUND
  Acromegaly is a chronic, debilitating and disfiguring condition with a significantly increased morbidity and mortality due to cardiovascular, as well as respiratory complications. Patients with acromegaly are usually diagnosed at the age of 40, however, the duration of symptoms can vary from 5 to 10 years before the formal diagnosis is confirmed. Recent advances in the field of acromegaly have improved survival significantly. A strong association between acromegaly and premalignant colonic lesions and colon cancer has been highlighted. Furthermore, patients with acromegaly have a greater lifetime risk of malignant transformation and a far worse overall prognosis from colorectal cancer, which is now considered a major disease related complication.
  
  
  METHODS
  A comprehensive search strategy was applied for the Medline/PubMed electronic database from its inception until April 2014. We considered all human research articles published in English, not classified as case report, editorial, comment, letter, or news.
  
  
  CONCLUSIONS
  Specific recommendations for large bowel endoscopic screening in patients with acromegaly have been proposed. In this comprehensive review we discuss the current state of knowledge and evidence on colonoscopic screening in patients with acromegaly illustrated by a case of aggressive colorectal cancer presenting late in a young woman with difficult to control acromegaly.
authors: Regional Pituitary Tumour Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, UK.
authors: K
authors: K
authors: Lois
authors: J
authors: J
authors: Bukowczan
authors: P
authors: P
authors: Perros
authors: S
authors: S
authors: Jones
authors: M
authors: M
authors: Gunn
authors: R A
authors: RA
authors: James
mesh_terms: D000172:Acromegaly / Q000150:complications*; D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis*; D000236:Adenoma / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications / Q000175:diagnosis*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D017410:Practice Guidelines as Topic; D011230:Precancerous Conditions / Q000150:complications / Q000175:diagnosis*