Risk of cancer in acromegaly patients: An updated meta-analysis and systematic review

Abstract

The incidence of cancer in acromegaly patients may be higher than that in the general population, although this has not been fully elucidated yet. This study analyzed the risk of various important types of cancer in acromegaly patients. The study was registered in INPLASY (registration number: INPLASY202340037). The PubMed, Web of Science, and EMBASE databases were searched for studies based on strict inclusion and exclusion criteria, from the time of database inception up to June 30, 2022. All observational studies of acromegaly patients with cancer were included, without language restrictions. We used the Newcastle–Ottawa scale (NOS) checklist to assess the quality of evidence. A meta-analysis revealed the relationship between acromegaly and cancer using the standardized incidence rates (SIRs) and 95% confidence intervals (CIs) retrieved from the included studies. Nineteen studies were included and analyzed. The overall incidence of cancer (SIR = 1.45, 95%CI = 1.20–1.75), as well as that of thyroid (SIR = 6.96, 95%CI = 2.51–19.33), colorectal and anal (SIR = 1.95, 95%CI = 1.32–2.87), brain and central nervous system (SIR = 6.14, 95%CI = 2.73–13.84), gastric (SIR = 3.09, 95%CI = 1.47–6.50), urinary (SIR = 2.66, 95%CI = 1.88–3.76), hematological (SIR = 1.89, 95%CI = 1.17–3.06), pancreatic and small intestine (SIR = 2.59, 95%CI = 1.58–4.24), and connective tissue (SIR = 3.15, 95%CI = 1.18–8.36) cancers, was higher among patients with acromegaly than among the general population. No association between acromegaly and hepatobiliary, respiratory, reproductive, skin, breast, or prostate cancer was observed. This study demonstrated that acromegaly patients have a modestly increased chance of cancer as compared to the general population. Risk factors for cancer need to be further explored to monitor patients with acromegaly at a high risk for cancer more carefully.