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Die
Behandlung mit Wachstumshormon wird derzeit aus vielfältigen Gründen
von Ärzten empfohlen bzw. von Patienten erbeten. Nun zeigt
eine in Großbritannien durchgeführte Studie, dass die Langzeitgabe
von Wachstumshormon das Risiko an Darmkrebs
oder Morbus Hodgkin zu sterben um das Elffache erhöht. Das
allgemeine Risiko des Krebstodes wird verdreifacht. Experten betonen,
dass dies nicht gegen die Anwendung des Wachstumshormons bei nachgewiesenem
Mangel spricht. Die Studie sollte aber weitere Forschung anregen
und das Bewusstsein für ein mögliches Krebsrisiko
erhöhen.
UK
STUDY SUGGESTS POSSIBLE LINK BETWEEN COLORECTAL CANCER AND HUMAN
GROWTH HORMONE THERAPY (p 273)
Authors of an observational study in this week’s issue of THE
LANCET highlight a possible link between human growth hormone
therapy and an increased risk of colorectal cancer. The investigators
comment that further evidence is required before firm conclusions
can be made, and stress that there is no evidence from their study
as to whether there is an association between modern synthetic
growth hormone treatment and increased cancer risk.
Human pituitary growth hormone was widely used to counteract short
stature in children and young adults up to the mid 1980s; since
then synthetic growth hormone has replaced human growth hormone
therapy. Previous research has suggested a possible link between
naturally occurring growth hormone concentrations and an increased
risk of cancer; however there are no long-term follow-up data
on growth-hormone-treated patients to support this association.
Anthony Swerdlow, Michael Preece, and colleagues from The Institute
of Cancer Research and Institute of Child Health, UK, did a population
study to investigate cancer incidence and death in 1848 people
in the UK who were treated during childhood and early adulthood
with human pituitary growth hormone between 1959 and 1985. The
risk of cancer in the study population was compared with that
in the general population.
Patients treated with human pituitary growth hormone had an almost
threefold increased risk of death from cancer
overall, and were at around an eleven
times greater risk of dying from colorectal cancer or Hodgkin’s
disease. After the exclusion of patients whose reason for
growth hormone treatment rendered them at a high risk of cancer,
the risk of incidence of colorectal cancer was significant, as
were the risks of death from colorectal cancer or Hodgkin’s disease.
Anthony Swerdlow comments: “Our data do not show conclusively
whether cancer incidence is increased by growth hormone treatment,
but they do suggest the need for increased awareness of the possibility
of cancer risks, and for surveillance of growth hormone-treated
patients.”
In an accompanying Commentary, Edward Giovannucci from Harvard
School of Public Health, Boston, USA, concludes: “It
must be emphasised 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. 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.”
Contact: Professor Anthony J Swerdlow, Section of Epidemiology,
Institute of Cancer Research, Cotswold Road, Sutton, Surrey, SM2
5NG,UK; T) +44 (0) 20 7970 6030;F) +44 (0) 20 8772 4019;E) amorgan@icr.ac.uk
or katy@icr.ac.uk
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