Cancer Risk After Growth Hormone Therapy

Abstract

Research Article| June 01 2017 Cancer Risk After Growth Hormone Therapy AAP Grand Rounds (2017) 37 (6): 71. https://doi.org/10.1542/gr.37-6-71 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Cancer Risk After Growth Hormone Therapy. AAP Grand Rounds June 2017; 37 (6): 71. https://doi.org/10.1542/gr.37-6-71 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: cancer, cancer risk, growth hormone therapy, recombinant human growth hormone, bladder cancer Source: Swerdlow AJ, Cooke R, Beckers D, et al. Cancer risks in patients treated with growth hormone in childhood: the SAGhE European cohort study. J Clin Endocrinol Metab. 2017; 102(5): 1661– 1672; doi: https://doi.org/10.1210/jc.2016-2046Google Scholar An international team of researchers from multiple institutions conducted a study to assess the effects of recombinant human growth hormone (r-hGH) treatment in childhood on future cancer incidence and mortality risks. Patients treated with r-hGH in 8 European countries were included in the study. In each of the countries, researchers assembled cohorts of patients treated with r-hGH in childhood, beginning at the time that this treatment was first used in that country, ranging from 1984 to 1986. Data on demographic and r-hGH–related variables were gathered from existing databases; cases of cancer and cancer mortality in study participants were determined by using data in national registries. The primary outcomes were cancer incidence and cancer mortality. The rates for these outcomes among study patients were compared to national and population rates in each of the 8 countries; effects of length of follow-up were also assessed. Subgroup analyses that included patients treated with r-hGH for an initial diagnosis of cancer or for isolated growth failure were also conducted. Data were available for calculating cancer mortality rates in 23,984 patients treated with r-hGH; cancer incidence could be calculated for 10,406 study participants. When compared to national rates, cancer mortality among study participants overall was increased more than 13-fold (P < .001), while cancer incidence was 2.2 times higher (P <.001). However, except for patients with bone and bladder cancers, these increased risks were due to the inclusion of patients whose original diagnosis that led to r-hGH treatment was cancer. The overall cancer risk and cancer mortality rate were not significantly higher for patients whose initial diagnosis was isolated growth failure. For study patients whose initial diagnosis was neither cancer nor growth failure, the risks of bone and bladder cancer after treatment with r-hGH were significantly increased, as was the overall cancer mortality rate. Among all study patients, there was a significant trend for an increased risk of Hodgkin lymphoma, with longer follow-up for study patients overall (P = .001) and for those without previous cancer (P = .002). The researchers conclude that these findings generally do not support a carcinogenic effect of r-hGH. However, they suggest that further study is needed, given the possible effects on bone cancer, bladder cancer, and Hodgkin lymphoma risks. Dr. Hogan has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. r-hGH, which has been approved by the Food and Drug Administration for clinical use since 1985, activates the production of insulin-like growth factor 1, resulting in possible interaction with oncogenes and tumor suppressors in vitro and in mouse models.1–6 Treatment with r-hGH has been associated with second neoplasms in... You do not currently have access to this content.