title: Incidence of primary cancers and intracranial tumour recurrences in GH-treated and untreated adult hypopituitary patients: analyses from the Hypopituitary Control and Complications Study.
abstract: OBJECTIVE
  Speculation remains that GH treatment is associated with increased neoplasia risk. Studies in GH-treated childhood cancer survivors suggested higher rates of second neoplasms, while cancer risk data for GH-treated and untreated hypopituitary adults have been variable. We present primary cancer risk data from the Hypopituitary Control and Complications Study (HypoCCS) with a focus on specific cancers, and assessment of recurrence rates for pituitary adenomas (PA) and craniopharyngiomas (CP).
  
  
  METHODS
  Incident neoplasms during HypoCCS were evaluated in 8418 GH-treated vs 1268 untreated patients for primary malignancies, 3668 GH-treated vs 720 untreated patients with PA history, and 956 GH-treated vs 102 untreated patients with CP history.
  
  
  METHODS
  Using population cancer rates, standardised incidence ratios (SIRs) were calculated for all primary cancers, breast, prostate, and colorectal cancers. Neoplasm rates in GH-treated vs untreated patients were analysed after propensity score adjustment of baseline treatment group imbalances.
  
  
  RESULTS
  During mean follow-up of 4.8 years, 225 primary cancers were identified in GH-treated patients, with SIR of 0.82 (95% CI 0.71-0.93). SIRs (95% CI) for GH-treated patients were 0.59 (0.36-0.90) for breast, 0.80 (0.57-1.10) for prostate, and 0.62 (0.38-0.96) for colorectal cancers. Cancer risk was not statistically different between GH-treated and untreated patients (relative risk (RR)=1.00 (95% CI 0.70-1.41), P=0.98). Adjusted RR for recurrence was 0.91 (0.68-1.22), P=0.53 for PA and 1.32 (0.53-3.31), P=0.55 for CP.
  
  
  CONCLUSIONS
  There was no increased risk for all-site cancers: breast, prostate or colorectal primary cancers in GH-treated patients during HypoCCS. GH treatment did not increase the risk of PA and CP recurrences.
authors: Lilly Research LaboratoriesErl Wood Manor, Windlesham, Surrey GU20 6PH, UKinVentiv Health ClinicalBurlington, Massachusetts 01803 USALilly Research LaboratoriesIndianapolis, Indiana 46285, USADivision of EndocrinologyDiabetes and Hypertension, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts 02115, USADepartment of EndocrinologySkånes University Hospital, Lund 221 85, SwedenDepartment of Epidemiology and Cancer ControlSt Jude Children's Research Hospital, Memphis, Tennessee 38105-3678, USA cjc@lilly.com.
authors: Christopher J
authors: CJ
authors: Child
authors: Lilly Research LaboratoriesErl Wood Manor, Windlesham, Surrey GU20 6PH, UKinVentiv Health ClinicalBurlington, Massachusetts 01803 USALilly Research LaboratoriesIndianapolis, Indiana 46285, USADivision of EndocrinologyDiabetes and Hypertension, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts 02115, USADepartment of EndocrinologySkånes University Hospital, Lund 221 85, SwedenDepartment of Epidemiology and Cancer ControlSt Jude Children's Research Hospital, Memphis, Tennessee 38105-3678, USA.
authors: Daniel
authors: D
authors: Conroy
authors: Lilly Research LaboratoriesErl Wood Manor, Windlesham, Surrey GU20 6PH, UKinVentiv Health ClinicalBurlington, Massachusetts 01803 USALilly Research LaboratoriesIndianapolis, Indiana 46285, USADivision of EndocrinologyDiabetes and Hypertension, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts 02115, USADepartment of EndocrinologySkånes University Hospital, Lund 221 85, SwedenDepartment of Epidemiology and Cancer ControlSt Jude Children's Research Hospital, Memphis, Tennessee 38105-3678, USA.
authors: Alan G
authors: AG
authors: Zimmermann
authors: Lilly Research LaboratoriesErl Wood Manor, Windlesham, Surrey GU20 6PH, UKinVentiv Health ClinicalBurlington, Massachusetts 01803 USALilly Research LaboratoriesIndianapolis, Indiana 46285, USADivision of EndocrinologyDiabetes and Hypertension, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts 02115, USADepartment of EndocrinologySkånes University Hospital, Lund 221 85, SwedenDepartment of Epidemiology and Cancer ControlSt Jude Children's Research Hospital, Memphis, Tennessee 38105-3678, USA.
authors: Whitney W
authors: WW
authors: Woodmansee
authors: Lilly Research LaboratoriesErl Wood Manor, Windlesham, Surrey GU20 6PH, UKinVentiv Health ClinicalBurlington, Massachusetts 01803 USALilly Research LaboratoriesIndianapolis, Indiana 46285, USADivision of EndocrinologyDiabetes and Hypertension, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts 02115, USADepartment of EndocrinologySkånes University Hospital, Lund 221 85, SwedenDepartment of Epidemiology and Cancer ControlSt Jude Children's Research Hospital, Memphis, Tennessee 38105-3678, USA.
authors: Eva Marie
authors: EM
authors: Erfurth
authors: Lilly Research LaboratoriesErl Wood Manor, Windlesham, Surrey GU20 6PH, UKinVentiv Health ClinicalBurlington, Massachusetts 01803 USALilly Research LaboratoriesIndianapolis, Indiana 46285, USADivision of EndocrinologyDiabetes and Hypertension, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts 02115, USADepartment of EndocrinologySkånes University Hospital, Lund 221 85, SwedenDepartment of Epidemiology and Cancer ControlSt Jude Children's Research Hospital, Memphis, Tennessee 38105-3678, USA.
authors: Leslie L
authors: LL
authors: Robison
mesh_terms: D000236:Adenoma / Q000139:chemically induced* / Q000453:epidemiology; D000328:Adult; D001943:Breast Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D003397:Craniopharyngioma / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000009:adverse effects* / Q000172:deficiency; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy* / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000139:chemically induced* / Q000453:epidemiology; D010911:Pituitary Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D011471:Prostatic Neoplasms / Q000139:chemically induced* / Q000453:epidemiology
chemical_list: D019382:Human Growth Hormone