Natural history of acromegaly: Incidences, re-operations, cancers, and mortality rates in a national cohort

BACKGROUND: Acromegaly is so rare that its natural history, including incidence, risk of cancers, and mortality rates remain elusive. This natural study utilized a nationwide database to provide a better understanding of acromegaly's disease course. METHODS: A cohort of 1,195 acromegaly patients were identified and followed-up from 1997 to 2013. Incidence, operation, and re-operation rates were calculated. Excessive mortality and cancer risk related to acromegaly were estimated by standardized mortality ratio (SMR) and standardized incidence ratio (SIR). RESULTS: The incidence was 2.78 per million-person-years, with little gender predominance (female vs male, 49.5% vs 50.5%, respectively). There was female predominance only among 50 and 60 year olds (incidence rate ratio: 1.37 and 1.43, p 1, approximately 2). CONCLUSION: Acromegaly is associated with an excessive risk of mortality and two-fold higher risk of cancers. Patients with acromegaly should be managed appropriately after the diagnosis.