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The role of colonoscopic screening in acromegaly revisited: review of current literature and practice guidelines

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Abstract

Introduction

Acromegaly is a chronic, debilitating and disfiguring condition with a significantly increased morbidity and mortality due to cardiovascular, as well as respiratory complications. Patients with acromegaly are usually diagnosed at the age of 40, however, the duration of symptoms can vary from 5 to 10 years before the formal diagnosis is confirmed. Recent advances in the field of acromegaly have improved survival significantly. A strong association between acromegaly and premalignant colonic lesions and colon cancer has been highlighted. Furthermore, patients with acromegaly have a greater lifetime risk of malignant transformation and a far worse overall prognosis from colorectal cancer, which is now considered a major disease related complication.

Materials and methods

A comprehensive search strategy was applied for the Medline/PubMed electronic database from its inception until April 2014. We considered all human research articles published in English, not classified as case report, editorial, comment, letter, or news.

Conclusion

Specific recommendations for large bowel endoscopic screening in patients with acromegaly have been proposed. In this comprehensive review we discuss the current state of knowledge and evidence on colonoscopic screening in patients with acromegaly illustrated by a case of aggressive colorectal cancer presenting late in a young woman with difficult to control acromegaly.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Regional Pituitary Tumour Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, UK

    K. Lois, J. Bukowczan, P. Perros & R. A. James

  2. Department of Endocrinology, North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, Cleveland, TS19 8PE, UK

    S. Jones

  3. Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, UK

    M. Gunn

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  1. K. Lois
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  2. J. Bukowczan
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  3. P. Perros
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  4. S. Jones
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  5. M. Gunn
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Correspondence to J. Bukowczan.

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Lois, K., Bukowczan, J., Perros, P. et al. The role of colonoscopic screening in acromegaly revisited: review of current literature and practice guidelines. Pituitary 18, 568–574 (2015). https://doi.org/10.1007/s11102-014-0586-5

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