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Letter
Colorectal screening guidelines in acromegaly
  1. I Perry1,
  2. P M Stewart1,
  3. K Kane1
  1. 1Division of Medical Sciences, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK
  1. Correspondence to:
    I Perry;
    ian.perryl{at}virgin.net

https://doi.org/10.1136/gut.52.9.1387

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    We write with concern regarding the recent “Screening guidelines for colorectal cancer and polyps in patients with acromegaly” (

    Gut2002;51(suppl V):V13–14.
    OpenUrlPubMed

    ). While there is little doubt that patients with acromegaly have an increased risk of developing colorectal cancer, the exact nature of this risk is far from clear. The endocrine literature has witnessed a significant debate, polarising two separate views. Jenkins and Fairclough advocate screening while Renehan et al suggest that the risk of colorectal cancer formation does not warrant screening or surveillance.1,2 The recommendations by Jenkins and Fairclough for a national screening programme, endorsed by the BSG and ACPBG, are based largely on a series of 222 patients enrolled in a colonoscopy programme in one centre. The principal finding of this study was a 13–14-fold increase in the risk of colorectal cancer in acromegalics relative to the general population. This is at odds with larger studies (n=1362,3 n=1041,4 n=16345) which overall indicate an increased colorectal cancer risk of 2.5–3-fold. Jenkins and Fairclough advocate an intensive screening protocol beginning at …

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