Factors related to prevalence of colonic polyps in acromegalic patients

Background : It has been suggested that acromegalic patients are at increased risk of developing colonic neoplasia. We evaluated the prevalence of colonic neoplasia and the relationships of clinical parameters of acromegalic activity with presence of colonic neoplasia in Korean acromegalic patients. Methods : In 30 patients with active acromegaly, colonoscopy was performed at the time of diagnosis. According to the endoscopic findings and histological classifications, the patients were grouped, and a number of clinical parameters of acromegalic activity were compared between those with and without colonic polyps. Results : Colonic polyps were detected in 17 (56.7%) in the 30 acromegalic patients with colonoscopic examinations; 7 (23.3%) hyperplastic and 10 (33.3%) adenomatous polyps. Those with colonic polyps were significantly older (52.29.46 years vs. 42.212.97 years, p=0.02) and also had significantly longer disease duration (11.87.52 years vs. 52.20 years, p=0.004) than those without ones. In 21 patients who were more than 40 years old, significant differences were found in disease duration (12.77.54 years vs. 5.02.68 years, p=0.026) and serum IGF-1 level (1311.9500.14 ng/mL vs. 715.9330.58 ng/mL, p=0.015) between those with and without colonic polyps. Conclusion : These results suggest that screening colonoscopy should be recommended in acromegalic patients who are more than 40 year-old, have long disease duration or have high serum IGF-1 level.