TOPLINE

Patients with acromegaly had a significantly higher risk for colorectal cancer, thyroid cancer (particularly in the first 5 years after diagnosis), and benign colorectal lesions than control individuals from the general population; however, the risk for overall cancer and cancer-specific mortality was not significantly elevated.

METHODOLOGY

• Researchers conducted a nationwide population-based cohort study in Denmark (1977-2021) to evaluate the long-term risk for cancer and cancer-specific mortality and to examine the use of colonoscopy and its outcomes in 809 patients diagnosed with acromegaly (mean age, 48.3 years; 51.5% women).
• All diagnoses of acromegaly were biochemically validated, and the patients were compared with 80,900 matched control individuals from the general population.
• The median follow-up duration was 12.2 years for the acromegaly group and 13.0 years for the control group.
• The incidence of cancer and colonoscopy outcomes (including benign colorectal lesions and colorectal cancer) were assessed across predefined windows (5 years before diagnosis and 0-1, 1-5, and 5-45 years after diagnosis); risks for all-cause and cancer-specific mortality were also evaluated over follow-up.

TAKEAWAY

• Compared with control individuals, patients with acromegaly had a significantly higher incidence of colorectal cancer from diagnosis onwards (incidence rate ratio [IRR], 1.78; 95% CI, 1.22-2.60), peaking at 1-5 years after diagnosis (IRR, 3.24; 95% CI, 1.53-6.88). They also had a twofold elevated incidence of localised colorectal cancer (IRR, 2.00; 95% CI, 1.21-3.30).
• The incidence of thyroid cancer was significantly higher before (IRR, 12.50; P = .02) and after (IRR, 3.68; P = .03) the diagnosis of acromegaly; this increased incidence was most prominent during the first year after diagnosis (IRR, 33.50; P < .01) but remained high up to 5 years after diagnosis (IRR, 15.58; P < .01).
• Benign colorectal lesions occurred more often in the acromegaly group both from diagnosis onwards (IRR, 2.32) and in the 5 years before diagnosis (IRR, 2.62; P < .01 for both). Tubular adenomas (43.6%) were the predominant subtypes, followed by hyperplastic polyps (33.2%).
• The overall incidence of cancer and cancer-specific mortality did not differ between the acromegaly and control groups; however, all-cause mortality was higher in the acromegaly group.

IN PRACTICE

"The low occurrence of disseminated colorectal cancer suggests that adherence to the national FIT [faecal immunochemical test]-based screening program is safe and demonstrates reassuring outcomes in patients with acromegaly," the authors wrote.

SOURCE

This study was led by Christian Rosendal, Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark. It was published online on July 06, 2026, in the European Journal of Endocrinology.

LIMITATIONS

Data on height, weight, smoking status, and outcomes of faecal occult blood tests were not available because the study was based on real-world data. Temporal changes in the incidence of cancer during the study period may have influenced the observed incidence of cancer, independent of acromegaly status.

DISCLOSURES

This study did not receive any funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.