Chief Cushie ~MaryO~ Posted Saturday at 06:45 PM Chief Cushie Report Share Posted Saturday at 06:45 PM I certainly know this to be true I'm an 18 year survivor of yet another disease that I shouldn't have gotten: kidney cancer. Key takeaways: Adults with Cushing’s syndrome have a 78% higher risk for any cancer compared with controls. Cushing’s syndrome is tied to a higher risk for genitourinary cancers, thyroid cancer and adrenocortical carcinoma. Adults diagnosed with endogenous Cushing’s syndrome have a higher risk for developing cancer compared with controls without the condition, according to data published in the European Journal of Endocrinology. In a retrospective analysis of data from the Clalit Health Services’ electronic health record database in Israel, 19% of adults with endogenous Cushing’s syndrome were diagnosed with cancer during a median follow-up of 14.7 years compared with 11.1% of adults without Cushing’s syndrome (HR = 1.78; 95% CI, 1.44-2.2). Data were derived from Rudman Y, et al. Eur J Endocrinol. 2024;doi:10.1093/ejendo/lvae098. Adults diagnosed with Cushing’s syndrome also had a greater risk for genitourinary cancers (HR = 1.63; 95% CI, 1.02-2.61), thyroid cancer (HR = 3.68; 95% CI, 1.68-8.01) and adrenocortical carcinoma (HR = 24.72; 95% CI, 2.89-211.56) than controls. Amit Akirov “Our study is the first to demonstrate an elevated cancer risk in patients with Cushing’s syndrome, highlighting the importance of raising awareness and the need to establish guideline recommendations for cancer screening in this population, especially for genitourinary, thyroid and gynecological cancers,” Amit Akirov, MD, associate professor in the faculty of medicine at Tel Aviv University and in the Endocrine Institute at Rabin Medical Center in Petach-Tikva, Israel, told Healio. Akirov and colleagues obtained health record data for 609 adults diagnosed with Cushing’s syndrome from 2000 to June 2023 (mean age at diagnosis, 48.1 years; 65% women; 41.2% with Cushing’s disease, 32.8% with adrenal Cushing’s syndrome; 25.9% with undetermined etiology). Those with Cushing’s syndrome were matched, 1:5, by age, sex, socioeconomic status and BMI with a control group of 3,018 adults who were never tested for hypercortisolism. The outcome of interest was the first diagnosis of any malignant cancer after Cushing’s syndrome diagnosis with the except of nonmelanoma skin cancer. The increased risk for cancer among those with Cushing’s syndrome was observed both among adults younger than 60 years (HR = 2.15; 95% CI, 1.63-2.84) and those aged 60 years and older (HR = 1.42; 95% CI, 1.02-1.98). Adults with obesity and Cushing’s syndrome had a higher risk for cancer than those with obesity and no hypercortisolism (HR = 2.21; 95% CI, 1.44-3.4). No difference in cancer risk was seen among adults without obesity. Akirov told Healio that the researchers suspected the presence of Cushing’s syndrome could increase cancer risk prior to conducting the study. “While some studies suggest that excess growth hormone or prolactin may be linked to an increased cancer risk, this association had not been previously examined in patients with Cushing’s syndrome,” Akirov said in an interview. “However, we hypothesized that elevated cortisol levels could provide a foundation for tumor development.” Adults with Cushing’s disease had a higher risk for any cancer (HR = 1.65; 95% CI, 1.15-2.36) and gynecological cancers (HR = 3.65; 95% CI, 1.16-11.52) than matched controls. Those with adrenal Cushing’s syndrome had an increased risk for any malignancy (HR = 2.36; 95% CI, 1.7-3.29), lung cancer (HR = 3.06; 95% CI, 1.11-8.42), genitourinary cancers (HR = 2.42; 95% CI, 1.22-4.82), thyroid cancer (HR = 4.97; 95% CI, 1.24-19.87) and adrenocortical carcinoma diagnosed more than 5 years after Cushing’s syndrome diagnosis (HR = 19.73; 95% CI, 2.21-176.5) than controls. More research is needed to confirm the findings, further assess which cancers adults with Cushing’s syndrome are at the greatest risk for being diagnosed with and whether there are any predictors for cancer in Cushing’s syndrome, according to Akirov. For more information: Amit Akirov, MD, can be reached at amit.akirov@gmail.com. Published by: Sources/Disclosures Source: Rudman Y, et al. Eur J Endocrinol. 2024;doi:10.1093/ejendo/lvae098. Disclosures: Akirov reports receiving occasional scientific fees for consulting and serving on advisory board for CTS Pharma, Medison and Neopharm. Please see the study for all other authors’ relevant financial disclosures. From https://www.healio.com/news/endocrinology/20240927/cancer-risk-elevated-for-adults-after-cushings-syndrome-diagnosis 1 Quote Link to comment Share on other sites More sharing options...
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