Pituitary · 2026
Cancer risk in a large acromegaly cohort: a standardized incidence ratio analysis.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ercan Polat, Yazgan Busra Firlatan, Sendur Suleyman Nahit, Dagdelen Selcuk, Erbas Tomris
Аннотация
PURPOSE: To evaluate overall and site-specific cancer risk in a large Turkish acromegaly cohort and assess the contribution of surveillance bias.
METHODS: We retrospectively analyzed 393 acromegaly patients followed at a single tertiary center (1980-2023). Standardized incidence ratios (SIRs) were calculated against Turkish national cancer rates. Sensitivity analyses included thyroid exclusion, graded landmarks (1, 2, 5 years), temporal restrictions, and reference rate variation (± 20%). Multivariable logistic regression assessed predictors of cancer, including cumulative IGF-1 exposure (time-weighted average, TWAvg×ULN).
RESULTS: Sixty-four patients (16.3%) developed cancer over a median follow-up of 9 years. The overall cancer SIR was 5.48 (95% CI: 4.15-7.10), driven by thyroid (46.25), renal/urinary (7.38), and breast cancer (3.75; all p < 0.001 except breast p = 0.006). The non-thyroid SIR remained significant at 2.76 (1.86-3.94, p < 0.001) and stable across graded landmarks (range 2.42-2.53; all p < 0.001) and other sensitivity analyses. TWAvg IGF-1 was higher in the cancer group (1.26 vs. 0.97 ×ULN; p = 0.002) and independently predicted cancer (OR: 1.80; 95% CI: 1.21-2.69; p = 0.004).
CONCLUSIONS: In this large single-center Turkish acromegaly cohort, the overall SIR (5.48) exceeded the pooled population-based estimate of 1.45. The non-thyroid SIR remained significant across all sensitivity analyses (range 2.22-3.45), indicating multi-site predisposition beyond surveillance bias. Cumulative IGF-1 exposure independently predicted cancer, supporting sustained hormonal excess as a driver of oncogenesis. These findings support systematic thyroid screening and heightened vigilance for non-thyroid malignancies in tertiary-managed acromegaly.
METHODS: We retrospectively analyzed 393 acromegaly patients followed at a single tertiary center (1980-2023). Standardized incidence ratios (SIRs) were calculated against Turkish national cancer rates. Sensitivity analyses included thyroid exclusion, graded landmarks (1, 2, 5 years), temporal restrictions, and reference rate variation (± 20%). Multivariable logistic regression assessed predictors of cancer, including cumulative IGF-1 exposure (time-weighted average, TWAvg×ULN).
RESULTS: Sixty-four patients (16.3%) developed cancer over a median follow-up of 9 years. The overall cancer SIR was 5.48 (95% CI: 4.15-7.10), driven by thyroid (46.25), renal/urinary (7.38), and breast cancer (3.75; all p < 0.001 except breast p = 0.006). The non-thyroid SIR remained significant at 2.76 (1.86-3.94, p < 0.001) and stable across graded landmarks (range 2.42-2.53; all p < 0.001) and other sensitivity analyses. TWAvg IGF-1 was higher in the cancer group (1.26 vs. 0.97 ×ULN; p = 0.002) and independently predicted cancer (OR: 1.80; 95% CI: 1.21-2.69; p = 0.004).
CONCLUSIONS: In this large single-center Turkish acromegaly cohort, the overall SIR (5.48) exceeded the pooled population-based estimate of 1.45. The non-thyroid SIR remained significant across all sensitivity analyses (range 2.22-3.45), indicating multi-site predisposition beyond surveillance bias. Cumulative IGF-1 exposure independently predicted cancer, supporting sustained hormonal excess as a driver of oncogenesis. These findings support systematic thyroid screening and heightened vigilance for non-thyroid malignancies in tertiary-managed acromegaly.