The value of colonoscopy in patients with asymptomatic acromegaly on the digestive plan

Aims Acromegaly is a disease linked to hypersecretion of growth hormone (GH). Current recommendations suggest including these patients in the high-risk group for colorectal cancer (CRC) and monitoring them by screening colonoscopy. The aim of our work is to evaluate the value of screening colonoscopy in patients with acromegaly who are asymptomatic on the digestive tract [1] [2] [3] [4].

Methods This is a retrospective study, including all patients followed up for acromegaly who underwent screening colonoscopy and who were asymptomatic on the digestive plan, over a 4-year period (January 2020- december 2023).

Results during this period, 39 patients underwent total screening colonoscopy, with an average age of 40 and a M/F sex ratio of 0.9.

Colonoscopy revealed polyps in 15 patients, with the number of polyps ranging from 1 to 4, except in one patient where colonoscopy revealed rectocolic polyposis. The mean size of the polyps was 9 mm, with a sessile appearance in 10 patients. Regarding location, 9 patients had polyps in the right colonic angle, 2 patients had colorectal polyps, 2 patients had sigmoid polyps, one patient had an isolated rectal polyp, while one patient had rectocolonic polyposis. All polyps were resected, while the patient with polyposis underwent excisional biopsies. Anatomopathological study was in favour of adenoma in all patients, without dysplasia in 12 cases, but with focal high-grade dysplasia in 3 patients who underwent a follow-up colonoscopy in 3 months, which returned normal. All our patients were enrolled in an endoscopic surveillance protocol, which subsequently revealed no abnormalities.

Conclusions Acromegaly is a risk factor for colorectal cancer, and our study confirms the importance of screening colonoscopy at the time of diagnosis, even in patients with asymptomatic digestive disease. Endocrinologists need to be made aware of this risk, to avoid the possible development of colorectal cancer.

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

• References

• 1 Terzolo M, Reimondo G, Gasperi M. et al. Colonoscopic screening and follow-up in patients with acromegaly: a multicenter study in Italy. J Clin Endocrinol Metab 2005; 90: 84-90
• 2 Iwamuro M, Yasuda M, Hasegawa K.. Colonoscopy examination requires a longer time in patients with acromegaly than in other individuals. Ann Endocr 2018; 65 (2): 151-7
• 3 Farih S, Ezzerrouqi A, Elilie F, Rouf S, Latrech H.. Les complications digestives de l’acromégalie : à propos de 5 cas. Endocr J 2016; 77: 350
• 4 Melmed S.. Medical progress: acromegaly. N Engl J Med 2006; 355: 2558-73

Publication History

Article published online:
27 March 2025