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Pituitary

, Volume 18, Issue 4, pp 568–574 | Cite as

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

  • K. Lois
  • J. BukowczanEmail author
  • P. Perros
  • S. Jones
  • M. Gunn
  • R. A. James
Article

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.

Keywords

Acromegaly Colonoscopy Adenoma Colorectal cancer Screening Guidelines 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • K. Lois
    • 1
  • J. Bukowczan
    • 1
    Email author
  • P. Perros
    • 1
  • S. Jones
    • 2
  • M. Gunn
    • 3
  • R. A. James
    • 1
  1. 1.Regional Pituitary Tumour ServiceNewcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
  2. 2.Department of EndocrinologyNorth Tees and Hartlepool NHS Foundation TrustStockton-on-Tees, ClevelandUK
  3. 3.Department of GastroenterologyNewcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK

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