Thyroid cancer is the most common cancer in patients with acromegaly: a retrospective cohort study in Japanese population at a single center

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 88-129-Acromegaly & Prolactinoma
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-112
Naotetsu Kanamoto*, Yoriko Ueda, Yui Yamashita, Eri Kondo, Toshihito Fujii, Masako Miura, Akihiro Yasoda, Hiroshi Arai and Kazuwa Nakao
Kyoto University Graduate School of Medicine, Kyoto, Japan
[Background]: Acromegaly is characterized by sustained elevation of circulating growth hormone (GH) and insulin-like growth factor I (IGF-I), and is clearly associated with increased morbidity and overall mortality mainly due to cardiovascular, metabolic, and respiratory diseases. Although cancers are the cause of death in 15% of patients with acromegaly, it is controversial whether cancer-related mortality for all patients with acromegaly is increased. Largest cohort studies demonstrated that increased mortality rates for all cancers only in patients with acromegaly with higher post-treatment GH levels. Also, the increase in the overall incidence of cancers in acromegaly remains controversial.

[Objective]: The aim of the study was to investigate the incidence of cancers in patients with acromegaly in Japanese population at a single center.

[Methods]: The medical records of 38 patients with diagnosis of acromegaly treated and followed at Kyoto University Hospital, Division of Endocrinology and Metabolism between 1978 and 2012 were reviewed retrospectively. The incidence of cancers was investigated.

[Results]: Thirty-eight patients (17 males and 21 females) with acromegaly provided 320 person-years of follow-up. The mean follow-up time was 8.4 years. Cancer was detected in seven (18.4%) patients (three in males and four in females) and there was no significant difference in the incidence of cancers between males and females. Thyroid cancer was found in four patients (10.5%), gastric cancer in two (5.3%), and nasal leiomyosarcoma in one (2.6%). All of the pathological subtypes in thyroid cancer were thyroid papillary carcinoma. All the patients with gastric cancer were diagnosed at earlier stages. Although colon polyp was detected in 14 patients, the occurrence of colon cancer was not observed.

[Conclusions]: Contrary to the previous reports that suggest colon cancer as the most common type in patients with acromegaly, thyroid cancer was the most common cancer type and occurred frequently among patients with acromegaly in this study. It was previously reported that the risk of thyroid cancer increases depending on duration of illness in patients with acromegaly who have past history of goiter or thyroid nodule. Our results suggest that screening for thyroid by ultrasound should be performed routinely to all newly diagnosed patients with acromegaly and monitored periodically, followed by fine-needle aspiration biopsy when required.

Nothing to Disclose: NK, YU, YY, EK, TF, MM, AY, HA, KN

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