Acromegaly, growth hormone and cancer risk.
Best Pract Res Clin Endocrinol Metab
; 22(4): 639-57, 2008 Aug.
Article
em En
| MEDLINE
| ID: mdl-18971124
ABSTRACT
Acromegaly is an endocrine disorder characterized by sustained hypersecretion of growth hormone (GH) with concomitant elevation of insulin-like growth factor I (IGF-I) associated with premature mortality from cardiopulmonary diseases and certain malignancies. In particular, there is a two-fold increased risk of developing colorectal cancer. Possible mechanisms underlying this association include elevated levels of circulating GH and IGF-I, but several other plausible processes may be relevant. In a parallel literature, there has been debate whether GH replacement therapy is associated with increased cancer risk in three scenarios (1) tumour recurrence in children with previously treated cancer; (2) second neoplasms (SNs) in survivors of childhood cancer treated with GH; and (3) de-novo cancer in non-cancer patients treated with GH. The general evidence suggests no increased risk in scenario 1. Through a maze of complex study designs, there is inconclusive evidence of a very modest increase in cancer risk in treated GH-deficiency patients in scenarios 2 and 3, but it is likely that the cumulative risk equates to that of the general population. This emphasizes the need for patient selection balanced against the known morbidity of untreated GH deficiency.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Acromegalia
/
Neoplasias da Glândula Tireoide
/
Neoplasias Colorretais
/
Hormônio do Crescimento Humano
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
Idioma:
En
Revista:
Best Pract Res Clin Endocrinol Metab
Assunto da revista:
ENDOCRINOLOGIA
/
METABOLISMO
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Reino Unido