Colorectal Cancer
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jun 14, 2008; 14(22): 3484-3489
Published online Jun 14, 2008. doi: 10.3748/wjg.14.3484
Risk of colorectal neoplasm in patients with acromegaly: A meta-analysis
Theodoros Rokkas, Dimitrios Pistiolas, Panos Sechopoulos, Georgios Margantinis, Georgios Koukoulis
Theodoros Rokkas, Dimitrios Pistiolas, Panos Sechopoulos, Georgios Margantinis, Georgios Koukoulis, Gastroenterology Clinic, Henry Dunant Hospital, 107 Messogion Ave., Athens 11526, Greece
Author contributions: Rokkas T conceived and designed the study, analysed data and wrote the paper; Pistiolas T analysed data and contributed to the writing of the paper; Sechopoulos P performed research and analysed data; Margantinis G and Koukoulis G performed research.
Correspondence to: Theodoros Rokkas, MD, PhD, FACG, AGAF, FEBG, Gastroenterology Clinic, Henry Dunant Hospital, Athens, Greece. sakkor@otenet.gr
Telephone: +30-210-6431334
Fax: +30-210-6431334
Received: February 16, 2008
Revised: April 25, 2008
Accepted: May 2, 2008
Published online: June 14, 2008
Abstract

AIM: To examine the risk of colorectal neoplasm in acromegalic patients by meta-analyzing all relevant controlled studies.

METHODS: Extensive English language medical literature searches for human studies, up to December 2007, were performed using suitable keywords. Pooled estimates [odds ratio (OR) with 95% confidence intervals (CI)] were obtained using either the fixed or random-effects model as appropriate. Heterogeneity between studies was evaluated with the Cochran Q test whereas the likelihood of publication bias was assessed by constructing funnel plots. Their symmetry was estimated by the adjusted rank correlation test.

RESULTS: For hyperplastic polyps the pooled ORs with 95% CI were 3.557 (2.587-4.891) by fixed effects model and 3.703 (2.565-5.347) by random effects model. The Z test values for overall effect were 7.81 and 6.984, respectively (P < 0.0001). For colon adenomas the pooled ORs with 95% CI were 2.486 (1.908-3.238) (fixed effects model) and 2.537 (1.914-3.364) (random effects model). The Z test values were 6.747 and 6.472, respectively (P < 0.0001). For colon cancer the pooled OR with 95% CI was identical for both fixed and random effects model (OR, 4.351; 95% CI, 1.533-12.354; Z = 2.762, P = 0.006). There was no significant heterogeneity and no publication bias in all the above meta-analyses.

CONCLUSION: Acromegaly is associated with an increased risk of colorectal neoplasm.

Keywords: Acromegaly; Colon cancer; Colon polyps; Colon neoplasia; Meta-analysis