Acromegaly and the risk of cancer: a nationwide population-based cohort study in Korea

INTRODUCTION: Using a nationwide population-based cohort, we primarily investigated whether overall and site-specific cancer risks are increased in patients with acromegaly. PATIENTS AND METHODS: The study included 2382 patients with acromegaly and 11 910 controls aged above 20, from 2006 to 2016. Cox hazards regression analysis was used, adjusting for baseline covariates. To investigate the association between acromegaly and cancer risk, we conducted Cox proportional hazards regression analysis with adjustments for age, sex, hypertension, diabetes, and dyslipidemia, and stratified the analysis by age (<50, 50-64, and ≥65 years), sex, and follow-up duration (<1, 1-4, and ≥5 years). RESULTS: Among the 2382 patients with acromegaly, overall cancer occurred in 244 (10.2%), while the 11 910 controls had 707 (5.9%) occurrences (HR: 1.90 (95% confidence interval (CI): 1.63-2.22). Patients with acromegaly had the highest relative risk for brain cancers with an HR of 6.80 (95% CI: 2.83-16.38) and significantly higher risk of lymphoma, thyroid cancer, multiple myeloma, pancreatic cancer, and colorectal cancer. Even 5 years after the diagnosis of acromegaly, patients continued to show a significantly higher incidence of cancer. The overall cancer risk, particularly for stomach cancer, was significantly higher in patients under the age of 50 compared to older patients. No significant difference was observed between sexes. CONCLUSIONS: This nationwide longitudinal cohort study shows an increased risk of cancer in patients with acromegaly Active and long-term cancer screening is necessary in patients with acromegaly.