Documented malignancy was found in 10 of 157 patients with acromegaly in a retrospective Gulf-region study, an observed proportion of 6.4%. Eight of the 10 cancers were papillary thyroid carcinoma; the remaining cases were one colorectal cancer and one prostate cancer. The study stressed that 6.4% describes this cohort, not excess cancer risk attributable to acromegaly.
The study drew on medical records for patients older than 16 with acromegaly who were evaluated from 2010 through 2024 at five tertiary care centers in three Gulf countries. Records that did not confirm acromegaly or allow assessment of the prespecified outcomes were excluded. The final cohort had a mean age of 47.1 years; 101 of 157 patients, or 64.3%, were male, and mean disease duration was 9.4 years.
Most cases involved the thyroid
Two of the eight papillary thyroid carcinomas were classified as T1a, a category corresponding to a tumor no more than 10 millimeters. Exact pathology measurements were not consistently available, so the recorded T categories should be treated as approximate size markers. The eight cases included two T1a, two T1b, three T2 and one T3b tumor; the T3b case had regional lymph-node involvement.
All patients with documented thyroid cancer underwent surgery. Two also received radioactive iodine, and all were recorded as having an excellent response at the last documented follow-up. The review did not provide a standardized duration of long-term follow-up, so these records do not provide a reliable long-term survival estimate.
The two non-thyroid cases were both stage I and were in remission at the last follow-up. The colorectal cancer was recorded in a 68-year-old woman with diarrhea and a family history, while the prostate cancer occurred in a 64-year-old man with obstructive urinary symptoms and a suspicious prostate nodule. Those single cases cannot estimate the risk of either cancer type or show that screening was effective.
Why the percentage needs caution
Patients with documented malignancy were older on average than those without it, with mean ages of 56.6 and 46.5 years. The reported P value was .039, but the comparison was exploratory because only 10 malignancy events were available. The authors did not interpret the P value as evidence for or against an association, and the age difference may also reflect confounding.
Testing patterns offered another reason for caution. Among patients with available data, thyroid ultrasonography was documented for 7 of 8 patients with malignancy and 91 of 134 without malignancy. Colonoscopy was documented for 7 of 10 with malignancy and 84 of 137 without. The indications for these tests were not consistently recorded, and testing was not standardized across centers. As a result, the comparisons cannot measure screening effectiveness or cancer risk.
The study's retrospective design, modest sample, only 10 cancer events, missing data and lack of a matched control group limit what can be concluded. Cancer ascertainment and testing varied, test indications were uncertain, and referral, survival, selection, surveillance and detection bias were possible.
The authors therefore support individualized surveillance guided by population guidance, symptoms, family history and clinical findings, rather than a screening program designed specifically for people with acromegaly. The conclusion reflects the study's limits: it describes what was documented in this cohort but does not determine whether acromegaly increases cancer risk.
Paper data and sources
Original title: Malignancy in patients with acromegaly: a multicenter study across the Gulf region.
Authors: AlDahmani K, Mahzari M, Elhadd TA et al.
Journal/Repository: Annals of Saudi medicine
Status: Peer-reviewed
First online: 2026-10-01
DOI: 10.5144/0256-4947.2026.368
Original paper · Full text