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Growth hormone treatment linked to increased cancer risk
NEW YORK (Reuters Health) - Results of a cohort study show that the risk of cancer, particularly colorectal cancer and Hodgkin's disease, is significantly increased among patients treated with human pituitary growth hormone.
Dr. Anthony J. Swerdlow from the Institute of Cancer Research, Surrey, UK, and colleagues collected data on 1848 patients who had received growth hormone during childhood and early adulthood from 1959 to 1985. The researchers obtained followup information on these patients regarding incidence of cancer until December 1995 and mortality until December 2000.
As reported in the July 27th issue of The Lancet, there was a significantly increased risk for death from cancer (standarized mortality ratio 2.8) and from colorectal cancer (standarized mortality ratio 10.8) and from Hodgkin's disease (standarized mortality ratio 11.4), the researchers found. The incidence of colorectal cancer was also increased (standarized incidence ratio 7.9), they add.
"Some of the raised risk was because of specific high-risk groups who received growth hormone," Dr. Swerdlow told Reuters Health. "But even after we removed those people from the analysis, there was significant raised risk for mortality from colorectal cancer and from Hodgkin's disease."
For colorectal cancer, there are reasons to believe that growth hormone might be involved in the etiology, he added.
At this point, physicians need to take these findings into account when they treat patients with growth hormone, Dr. Swerdlow said, but there needs to be more research to verify the findings.
"It must be emphasized that the treatment of growth hormone deficiency has established health benefits, and that there is no evidence that physiological growth-hormone replacement increases cancer risk," Dr. Edward Giovannucci from Brigham and Women's Hospital, Boston, and Dr. Michael Pollak from Jewish General Hospital, Montreal, comment in a journal editorial.
"While the data reported by Swerdlow and colleagues should not discourage appropriate treatment of growth hormone deficiency, they should provoke reassessment of the risks and benefits of growth hormone therapy for more controversial indications that are unrelated to growth hormone deficiency, particularly if such treatment is prescribed for long periods," they advise.