title: The Incidence of Cancer Among Acromegaly Patients: Results From the German Acromegaly Registry.
abstract: BACKGROUND
  Acromegaly is a rare disease characterized by high serum levels of GH and IGF-1. Animal studies have demonstrated links between these hormones and cancer, but data regarding cancer incidence among acromegaly patients are inconsistent. Moreover, therapy options have changed considerably since many of the aforementioned data were collected.
  
  
  OBJECTIVE
  The objective was to determine whether the overall and site-specific incidence of cancer is comparable to that of the general population.
  
  
  METHODS
  Data from the German Acromegaly Registry for 446 patients (6656 person-years from diagnosis) treated in seven specialized endocrine centers were analyzed.
  
  
  METHODS
  Standard incidence ratios (SIRs) were calculated as compared to the general population.
  
  
  RESULTS
  Overall cancer incidence was slightly but not significantly lower than in the general population (SIR, 0.75; 95% confidence interval, 0.55 to 1.00; P = .051) and was not significantly higher for colorectal, breast, thyroid, prostate, and lung cancers. The SIRs of those with GH in the ranges <1, 1-2.5, and ≥ 2.5 ng/mL were 0.75, 0.44, and 0.92, respectively (P = .94). There was not a significant dependence on normal vs elevated IGF-1 (P = .87), radiation therapy (P = .45), disease duration (P = .96), age at diagnosis (P = .15), or during a period of high GH and IGF-1 from 8 years before to 2 years after diagnosis of acromegaly (P = .41).
  
  
  CONCLUSIONS
  Cancer screening strategies need to take incidence into account, which does not seem to be substantially higher in treated acromegaly patients than in the general population for any site of cancer.
authors.affiliation: Clinical Trial Center (D.P.) and Medical Department (A.T., M.M.), Division of Endocrinology and Nephrology, University of Leipzig, 04107 Leipzig, Germany; Center of Endocrinology and Diabetes (M.G.), 70178 Stuttgart, Germany; Endocrine Practice (M.D.), 26122 Oldenburg, Germany; Max Planck Institute of Psychiatry (C.D., G.S.), 80804 Munich, Germany; Department of Endocrinology (C.J.-H.), German Clinic of Diagnostics, 65191 Wiesbaden, Germany; Medizinische Klinik IV (J.S.), Ludwig-Maximilians-University, 80539 Munich, Germany; and Division of Endocrinology and Diabetes (C.S.), Department of Medicine I, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Petroff
authors.affiliation: Clinical Trial Center (D.P.) and Medical Department (A.T., M.M.), Division of Endocrinology and Nephrology, University of Leipzig, 04107 Leipzig, Germany; Center of Endocrinology and Diabetes (M.G.), 70178 Stuttgart, Germany; Endocrine Practice (M.D.), 26122 Oldenburg, Germany; Max Planck Institute of Psychiatry (C.D., G.S.), 80804 Munich, Germany; Department of Endocrinology (C.J.-H.), German Clinic of Diagnostics, 65191 Wiesbaden, Germany; Medizinische Klinik IV (J.S.), Ludwig-Maximilians-University, 80539 Munich, Germany; and Division of Endocrinology and Diabetes (C.S.), Department of Medicine I, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany.
authors.forename: Anke
authors.initials: A
authors.lastname: Tönjes
authors.affiliation: Clinical Trial Center (D.P.) and Medical Department (A.T., M.M.), Division of Endocrinology and Nephrology, University of Leipzig, 04107 Leipzig, Germany; Center of Endocrinology and Diabetes (M.G.), 70178 Stuttgart, Germany; Endocrine Practice (M.D.), 26122 Oldenburg, Germany; Max Planck Institute of Psychiatry (C.D., G.S.), 80804 Munich, Germany; Department of Endocrinology (C.J.-H.), German Clinic of Diagnostics, 65191 Wiesbaden, Germany; Medizinische Klinik IV (J.S.), Ludwig-Maximilians-University, 80539 Munich, Germany; and Division of Endocrinology and Diabetes (C.S.), Department of Medicine I, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Grussendorf
authors.affiliation: Clinical Trial Center (D.P.) and Medical Department (A.T., M.M.), Division of Endocrinology and Nephrology, University of Leipzig, 04107 Leipzig, Germany; Center of Endocrinology and Diabetes (M.G.), 70178 Stuttgart, Germany; Endocrine Practice (M.D.), 26122 Oldenburg, Germany; Max Planck Institute of Psychiatry (C.D., G.S.), 80804 Munich, Germany; Department of Endocrinology (C.J.-H.), German Clinic of Diagnostics, 65191 Wiesbaden, Germany; Medizinische Klinik IV (J.S.), Ludwig-Maximilians-University, 80539 Munich, Germany; and Division of Endocrinology and Diabetes (C.S.), Department of Medicine I, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Droste
authors.affiliation: Clinical Trial Center (D.P.) and Medical Department (A.T., M.M.), Division of Endocrinology and Nephrology, University of Leipzig, 04107 Leipzig, Germany; Center of Endocrinology and Diabetes (M.G.), 70178 Stuttgart, Germany; Endocrine Practice (M.D.), 26122 Oldenburg, Germany; Max Planck Institute of Psychiatry (C.D., G.S.), 80804 Munich, Germany; Department of Endocrinology (C.J.-H.), German Clinic of Diagnostics, 65191 Wiesbaden, Germany; Medizinische Klinik IV (J.S.), Ludwig-Maximilians-University, 80539 Munich, Germany; and Division of Endocrinology and Diabetes (C.S.), Department of Medicine I, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Dimopoulou
authors.affiliation: Clinical Trial Center (D.P.) and Medical Department (A.T., M.M.), Division of Endocrinology and Nephrology, University of Leipzig, 04107 Leipzig, Germany; Center of Endocrinology and Diabetes (M.G.), 70178 Stuttgart, Germany; Endocrine Practice (M.D.), 26122 Oldenburg, Germany; Max Planck Institute of Psychiatry (C.D., G.S.), 80804 Munich, Germany; Department of Endocrinology (C.J.-H.), German Clinic of Diagnostics, 65191 Wiesbaden, Germany; Medizinische Klinik IV (J.S.), Ludwig-Maximilians-University, 80539 Munich, Germany; and Division of Endocrinology and Diabetes (C.S.), Department of Medicine I, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany.
authors.forename: Günter
authors.initials: G
authors.lastname: Stalla
authors.affiliation: Clinical Trial Center (D.P.) and Medical Department (A.T., M.M.), Division of Endocrinology and Nephrology, University of Leipzig, 04107 Leipzig, Germany; Center of Endocrinology and Diabetes (M.G.), 70178 Stuttgart, Germany; Endocrine Practice (M.D.), 26122 Oldenburg, Germany; Max Planck Institute of Psychiatry (C.D., G.S.), 80804 Munich, Germany; Department of Endocrinology (C.J.-H.), German Clinic of Diagnostics, 65191 Wiesbaden, Germany; Medizinische Klinik IV (J.S.), Ludwig-Maximilians-University, 80539 Munich, Germany; and Division of Endocrinology and Diabetes (C.S.), Department of Medicine I, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Jaursch-Hancke
authors.affiliation: Clinical Trial Center (D.P.) and Medical Department (A.T., M.M.), Division of Endocrinology and Nephrology, University of Leipzig, 04107 Leipzig, Germany; Center of Endocrinology and Diabetes (M.G.), 70178 Stuttgart, Germany; Endocrine Practice (M.D.), 26122 Oldenburg, Germany; Max Planck Institute of Psychiatry (C.D., G.S.), 80804 Munich, Germany; Department of Endocrinology (C.J.-H.), German Clinic of Diagnostics, 65191 Wiesbaden, Germany; Medizinische Klinik IV (J.S.), Ludwig-Maximilians-University, 80539 Munich, Germany; and Division of Endocrinology and Diabetes (C.S.), Department of Medicine I, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany.
authors.forename: Manuel
authors.initials: M
authors.lastname: Mai
authors.affiliation: Clinical Trial Center (D.P.) and Medical Department (A.T., M.M.), Division of Endocrinology and Nephrology, University of Leipzig, 04107 Leipzig, Germany; Center of Endocrinology and Diabetes (M.G.), 70178 Stuttgart, Germany; Endocrine Practice (M.D.), 26122 Oldenburg, Germany; Max Planck Institute of Psychiatry (C.D., G.S.), 80804 Munich, Germany; Department of Endocrinology (C.J.-H.), German Clinic of Diagnostics, 65191 Wiesbaden, Germany; Medizinische Klinik IV (J.S.), Ludwig-Maximilians-University, 80539 Munich, Germany; and Division of Endocrinology and Diabetes (C.S.), Department of Medicine I, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Schopohl
authors.affiliation: Clinical Trial Center (D.P.) and Medical Department (A.T., M.M.), Division of Endocrinology and Nephrology, University of Leipzig, 04107 Leipzig, Germany; Center of Endocrinology and Diabetes (M.G.), 70178 Stuttgart, Germany; Endocrine Practice (M.D.), 26122 Oldenburg, Germany; Max Planck Institute of Psychiatry (C.D., G.S.), 80804 Munich, Germany; Department of Endocrinology (C.J.-H.), German Clinic of Diagnostics, 65191 Wiesbaden, Germany; Medizinische Klinik IV (J.S.), Ludwig-Maximilians-University, 80539 Munich, Germany; and Division of Endocrinology and Diabetes (C.S.), Department of Medicine I, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Schöfl
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D005260:Female; D005858:Germany; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D015994:Incidence; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D012042:Registries
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I