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Increased Prevalence of Colorectal Polyp in Acromegaly Patients: A Case-Control Study

DOI: 10.1155/2014/152049

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Abstract:

An increase in the prevalence of colorectal polyps and cancer is reported in patients with acromegaly. This trial is designed to determine whether there is an increase in the prevalence of colorectal polyps/cancer in Turkish acromegaly patients. Sixty-six patients, who were under follow-up with the diagnosis of acromegaly and underwent total colonoscopic examination, were enrolled in the study. Sixty-five age- and gender-matched patients with nonspecific complaints were selected as control. The mean age of acromegalic patients was years of whom 27 (40.9%) were females. In 20 (30.3%) of the patients with acromegaly a total of 65 colorectal polyps were detected. Forty-seven (72.3%) of the polyps were detected at the rectosigmoid region. In 8 (12.3%) of the 65 control patients a total of 17 polyps were found. There was a statistically significant difference between the groups . At the logistic regression analysis we found that the risk for colon polyps increased 3.2-fold in the presence of acromegaly, irrespective of age and gender (OR: 3.191, 95% CI: 1.25–8.13). In conclusion, patients who were followed up with the diagnosis of acromegaly should be taken to the colonoscopic surveillance program and all polyps detected should be excised in order to protect them from colorectal cancer. 1. Introduction Acromegaly is a disorder which usually results from a pituitary adenoma and is manifested with the increased circulating levels of growth hormone (GH) and insulin-like factor type 1 (IGF-1) and is characterized by overdevelopment of the distal bones, soft tissue, and the internal organs. The life expectancy is usually shorter than the normal population due to cardiovascular, pulmonary, and cerebrovascular causes [1]. Recent studies report a higher prevalence of colorectal cancer and polyp in acromegaly patients compared to the normal population [2–10]. Colorectal cancer, one of the most common cancers observed in the overall population, is known to occur highly on the basis of adenomatous polyps. Detection and removal of polyps via colonoscopic screening were proven to reduce the mortality associated with colorectal cancer [11, 12]. Since colorectal polyps and cancers are considered to develop earlier due to the effects of increased GH and IGF-1 in acromegaly patients, it may be appropriate to perform a colonoscopy screening in acromegaly patients more frequently and earlier relative to the overall population. Therefore, certain guidelines indicate the need for colonoscopic monitoring performed every 3 to 5 years, starting from the age of 40 in acromegaly

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