Abstract
Acromegaly results in a significantly increased morbidity and mortality due to cardiovascular and respiratory complications, as well as malignancies arising mainly from the colon. Furthermore, an increased lifetime risk of malignant transformation of pre-malignant colonic lesions relates to a worse overall prognosis from colorectal cancer, which is currently considered a major disease-related complication. In this review we provide some insight into colonic changes in this condition, summarize current knowledge and evidence on the use of colonoscopic screening in patients with acromegaly, and suggest a recommended screening protocol.
Highlights
Is a rare disease with an annual incidence of ∼4–6 cases per million per year, with an equal distribution between genders
The mortality rate due to colon cancer was found to be increased in relation to high growth hormone (GH) levels [14], but disease activity seemed not to play any major role in patients who had no colorectal lesions at their first colonoscopy [64] [ it is worth to note that in a recent case report a patient died from colon cancer with negative initial colonoscopy [12]]
As noted and discussed above, it is generally accepted that the prevalence of colon polyposis/malignancies is increased in patients with acromegaly
Summary
Results in a significantly increased morbidity and mortality due to cardiovascular and respiratory complications, as well as malignancies arising mainly from the colon. An increased lifetime risk of malignant transformation of pre-malignant colonic lesions relates to a worse overall prognosis from colorectal cancer, which is currently considered a major disease-related complication. In this review we provide some insight into colonic changes in this condition, summarize current knowledge and evidence on the use of colonoscopic screening in patients with acromegaly, and suggest a recommended screening protocol. Edited by: Cesar Luiz Boguszewski, Serviço de Endocrinologia e Metabologia do Hospital de Clínicas (SEMPR), Brazil. Reviewed by: Kosma Wolinski, Poznan University of Medical Sciences, Poland Selcuk Dagdelen, Hacettepe University, Turkey. Specialty section: This article was submitted to Pituitary Endocrinology, a section of the journal Frontiers in Endocrinology
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