Among patients who underwent colonoscopy, the prevalence of colon polyps was higher for ACRO patients, suggesting the need for new strategies to ensure adherence to colonoscopy guidelines.Īcromegaly Colonoscopy Polyposis Real life practice. In real-life practice, adherence to ACRO colonoscopy clinical guidelines was lower than expected. No cancerous polyps were detected in our analysis. The question as to whether the increased risk of colorectal cancers in acromegaly results in. The general risk of polyps and adenomatous polyps in ACRO patients was higher compared to the control population of Veneto Region, Italy (odds ratio 1.33 and 1.16, respectively). important colonoscopy findings were adenoma in 55 patients (23.4. Polyps were detected in 48% of untreated patients and in 26% of patients under treatment for acromegaly (p = 0.04). The presence of polyps was significantly associated with mean levels of growth hormone (GH), insulin-like growth factor 1 (IGF-1), fasting glucose and insulin levels (p < 0.05). Among the 146 ACRO patients, 68% were subjected to at least one colonoscopy and in 32% of the cases a polyp was detected during the procedure. Colonoscopy procedures were performed according to guidelines in 25% of ACRO patients at diagnosis, 51% at follow-up and 11% globally (both at diagnosis and follow-up). The total number of colonoscopies performed in ACRO patients increased from 6 in the period 1990-1994 to 57 in the period 2010-2014. We evaluated colonoscopy data, focusing on the correlation between colonoscopy findings and hormonal/metabolic values. We conducted a retrospective observational non-interventional and cross-sectional analysis on 146 patients with acromegaly (ACRO) referred to our clinic. This supports the recommendation to perform screening colonoscopy at diagnosis of acromegaly.The aim of this study is to investigate guideline application and colonoscopy findings in real-life practice in acromegaly. The presence of insulin resistance was the only statistically significant associated factor among acromegalic patients with and without colonic polyps.Ĭonclusions: Our findings show an increased risk of preneoplastic colonic lesions and colorectal carcinoma in patients with chronic and sustained GH excess compared to a control group. Advanced adenomas and colorectal carcinomas were found in 18 (27.3%) and 9 (7.0%) (p = 0,0006-OR: 4,57), and 4 (5.7%) and 0 (0.0%) p = 0.0063) of patients and controls respectively. Non precancerous polyps were found in 11 (15.7%) and 23 (17.9%) (p = 0.690), while advanced neoplastic lesions were found in 22 (31.4%) and 9 (7.0%) (p = 0,0001 - OR: 6.06) patients and controls respectively. Results: Thirty three out of 70 acromegalic patients and 32 out of 128 subjects controls presented polyps in the colonoscopy. The association of fasting insulin concentrations and colonic neoplasms in acromegaly: a colonoscopy-based study in 210 patients, Journal of Clinical Endocrinology and Metabolism, vol. Polyps were classified into non pre-cancerous lesions and advance neoplastic lesions which included advanced adenomas (preneoplastic) and colorectal carcinomas. Screening will depend on the initial findings, whether IGF-I is normal or high, and on the patient’s age. Full length colonoscopy of 70 acromegalic patients and 128 control subjects were studied. Methods: This is a case-control retrospective study. The main objective of this Argentine multicenter study was to analyze through screening colonoscopy the presence of advanced neoplastic lesions considered as precancerous, in patients with acromegaly compared to a control group. Purpose: Current international guidelines recommend colonoscopy in patients with acromegaly at the time of diagnosis, even though the risk of developing colorectal neoplasm is still controversial.
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