The prevalence and characteristics of colorectal neoplasia in acromegaly.

2.50
Hdl Handle:
http://hdl.handle.net/10541/86526
Title:
The prevalence and characteristics of colorectal neoplasia in acromegaly.
Authors:
Renehan, Andrew G; Bhaskar, Pudhupalayan; Painter, John E; O'Dwyer, Sarah T; Haboubi, Najib; Varma, Jag; Ball, Stephen G; Shalet, Stephen M
Abstract:
An increased prevalence of colorectal neoplasia has been reported in acromegalic patients, and recommendations have been made for early colonoscopic screening and regular surveillance. This assumption, however, is frequently drawn from studies using selected control populations. To clarify colonoscopic management in these patients, we undertook a 2-center prospective screening colonoscopy study in 122 acromegalics (age range, 25-82 yr). In the absence of ideal age-matched controls, we calculated prevalence rates of occult adenocarcinomas and adenomas in the general population using cumulative data in the published literature from 8 autopsy studies (model 1, n = 3,559) and 4 screening colonoscopy studies (model 2, n= 810), applying linear regression models. Of the 115 patients with complete examinations, adenocarcinomas were discovered in 3 (2.6%), and at least 1 adenoma was found in 11, giving an overall prevalence of neoplasia of 12% (14 of 115). Prevalence rates for age bands 30-40, 40-49, 50-59, 60-69, and 70+ yr were 0%, 8%, 12%, 20%, and 21%, respectively. Compared with the 2 control models, the prevalence of occult colorectal cancer was not significantly increased (acromegalics vs. models 1 and 2, 2.6% vs. 2.3% and 0.9%), nor was there an increase in the prevalence of adenomas in any age band. Pathological characteristics showed some differences, in that adenomas in acromegalics tended to be right sided (68% vs. 57% and 56%), larger (for > or =10 mm, 27% vs. 13% and 9%), and of advanced histology (for tubulovillous, 27% vs. 4% and 22%). No associations were found between the presence of colonic neoplasia and the duration of disease, total GH exposure, cure status, and serum insulin-like growth factor I. This study has failed to demonstrate an increased prevalence of neoplasia in acromegalic patients compared with the expected prevalence in the general population and questions the need for an aggressive colonoscopic screening policy.
Affiliation:
Department of Surgery, Christie Hospital National Health Service Trust, Manchester, United Kingdom. arenehan@picr.man.ac.uk
Citation:
The prevalence and characteristics of colorectal neoplasia in acromegaly. 2000, 85 (9):3417-24 J. Clin. Endocrinol. Metab.
Journal:
The Journal of Clinical Endocrinology and Metabolism
Issue Date:
Sep-2000
URI:
http://hdl.handle.net/10541/86526
DOI:
10.1210/jc.85.9.3417
PubMed ID:
10999843
Type:
Article
Language:
en
ISSN:
0021-972X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorRenehan, Andrew Gen
dc.contributor.authorBhaskar, Pudhupalayanen
dc.contributor.authorPainter, John Een
dc.contributor.authorO'Dwyer, Sarah Ten
dc.contributor.authorHaboubi, Najiben
dc.contributor.authorVarma, Jagen
dc.contributor.authorBall, Stephen Gen
dc.contributor.authorShalet, Stephen Men
dc.date.accessioned2009-11-19T17:05:18Z-
dc.date.available2009-11-19T17:05:18Z-
dc.date.issued2000-09-
dc.identifier.citationThe prevalence and characteristics of colorectal neoplasia in acromegaly. 2000, 85 (9):3417-24 J. Clin. Endocrinol. Metab.en
dc.identifier.issn0021-972X-
dc.identifier.pmid10999843-
dc.identifier.doi10.1210/jc.85.9.3417-
dc.identifier.urihttp://hdl.handle.net/10541/86526-
dc.description.abstractAn increased prevalence of colorectal neoplasia has been reported in acromegalic patients, and recommendations have been made for early colonoscopic screening and regular surveillance. This assumption, however, is frequently drawn from studies using selected control populations. To clarify colonoscopic management in these patients, we undertook a 2-center prospective screening colonoscopy study in 122 acromegalics (age range, 25-82 yr). In the absence of ideal age-matched controls, we calculated prevalence rates of occult adenocarcinomas and adenomas in the general population using cumulative data in the published literature from 8 autopsy studies (model 1, n = 3,559) and 4 screening colonoscopy studies (model 2, n= 810), applying linear regression models. Of the 115 patients with complete examinations, adenocarcinomas were discovered in 3 (2.6%), and at least 1 adenoma was found in 11, giving an overall prevalence of neoplasia of 12% (14 of 115). Prevalence rates for age bands 30-40, 40-49, 50-59, 60-69, and 70+ yr were 0%, 8%, 12%, 20%, and 21%, respectively. Compared with the 2 control models, the prevalence of occult colorectal cancer was not significantly increased (acromegalics vs. models 1 and 2, 2.6% vs. 2.3% and 0.9%), nor was there an increase in the prevalence of adenomas in any age band. Pathological characteristics showed some differences, in that adenomas in acromegalics tended to be right sided (68% vs. 57% and 56%), larger (for > or =10 mm, 27% vs. 13% and 9%), and of advanced histology (for tubulovillous, 27% vs. 4% and 22%). No associations were found between the presence of colonic neoplasia and the duration of disease, total GH exposure, cure status, and serum insulin-like growth factor I. This study has failed to demonstrate an increased prevalence of neoplasia in acromegalic patients compared with the expected prevalence in the general population and questions the need for an aggressive colonoscopic screening policy.en
dc.language.isoenen
dc.subjectColorectal Canceren
dc.subject.meshAcromegaly-
dc.subject.meshAdenocarcinoma-
dc.subject.meshAdenoma-
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshColonic Polyps-
dc.subject.meshColorectal Neoplasms-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshInsulin-Like Growth Factor Binding Protein 2-
dc.subject.meshInsulin-Like Growth Factor Binding Protein 3-
dc.subject.meshInsulin-Like Growth Factor I-
dc.subject.meshInsulin-Like Growth Factor II-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.titleThe prevalence and characteristics of colorectal neoplasia in acromegaly.en
dc.typeArticleen
dc.contributor.departmentDepartment of Surgery, Christie Hospital National Health Service Trust, Manchester, United Kingdom. arenehan@picr.man.ac.uken
dc.identifier.journalThe Journal of Clinical Endocrinology and Metabolismen

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