The changing landscape of acromegaly – an epidemiological perspective

Changes in acromegaly comorbidities, treatment, and outcome over three decades: a nationwide cohort study

“…Possible explanations may include decreasing diagnostic delay, as has been reported from other cohorts ( 14 ), or improvements in disease control. Lastly, disease characteristics have been described as becoming milder ( 13 ), possibly providing the basis for the stable cancer risk. In the present study, however, we did not observe a statistically significant decline in IGF-I levels at diagnosis, whereas we did find a significant decrease in both fasting and nadir GH levels at diagnosis.…”

“…The decrease in mortality is in keeping with a meta-analysis from 2018, where the standardized mortality ratio in acromegaly was found to be lower in more recent publications, as compared to earlier studies, and causes of death were shifting from cardiovascular to neoplastic ( 27 ). However, cancer-related mortality has not been found to be increased when compared to the background population ( 13 ). Moreover, the types of cancer observed in acromegaly patients seem to have become more diverse in recent surveys ( 21 , 27 ), which has been attributed to the increasing life expectancy of patients with acromegaly, exposing them to cancers typically associated with aging and environmental factors ( 16 , 18 , 27 ).…”

“…The disease is rare with incidence rates of 3.1 to 5.3 cases/million/year (2)(3)(4)(5)(6)(7)(8) and a reported prevalence (per million) in newer studies ranging from 83 to 137 (3,4,6,9,10). The incidence appears to increase, and a shift toward a milder disease phenotype has been suggested (4,(11)(12)(13). Disease onset is slow and insidious, and a diagnostic delay of 4-10 years is not uncommon (1,14), which carries a risk of irreversible complications (1).…”