![]() ![]() This indicates which particular studies are most influential and might help in the evaluation of the possibility that the conclusions result from the influence of a particular study. ![]() ![]() These analyses were achieved by repeating the meta-analyses with exclusion of each individual study one at a time, in order to assess the overall effect of each study on the pooled ORs. In the presence of significant statistical heterogeneity, sensitivity analyses were performed to search for the possible sources, such as sample size of each study, etc. Heterogeneity between studies was evaluated with the Cochran Q test and it was considered to be present if the Q test provided a P value of less than 0.10. Forest plots were constructed for visual display of OR (95% CI) of individual studies and pooled data. We calculated the pooled odds ratios (ORs) and 95% confidence intervals (CI) and compared outcomes of individual studies by using the fixed or the random effects model as appropriate. This study is justified by the fact that, so far, no meta-analysis has been published examining the relationship between acromegaly and colorectal neoplasia.Īgreement in the selection of studies between the 2 reviewers was evaluated by the κ coefficient. Secondary aims were to explore the possibility of heterogeneity between studies and to look for the existence of publication bias. The main aim of this meta-analysis, therefore, was to examine the pooled risk of colorectal neoplasia (polyps and cancer) in acromegalic patients by meta-analyzing all relevant controlled studies. Moreover, the reported higher indices of colorectal neoplasia in acromegalics have not been a universal finding. However, reported relative risks of colorectal cancer vary significantly depending on the study population and the study design. Colon cancer incidence and mortality rates have been reported to be higher in acromegalics than expected. ![]() Acromegalics may also be at an increased risk for malignancies in several systems including the digestive tract, brain, kidney, breast and prostate. Acromegalic patients have a reduced life expectancy primarily due to cardiovascular, respiratory or cerebrovascular disease. There was no significant heterogeneity and no publication bias in all the above meta-analyses.ĬONCLUSION: Acromegaly is associated with an increased risk of colorectal neoplasm.Īcromegaly is a disease caused by excess secretion of growth hormone (GH), which is characterized by enlarged acral parts, coarse facial features, and visceromegaly. For colon cancer the pooled OR with 95% CI was identical for both fixed and random effects model (OR, 4.351 95% CI, 1.533-12.354 Z = 2.762, P = 0.006). The Z test values were 6.747 and 6.472, respectively ( P < 0.0001). The Z test values for overall effect were 7.81 and 6.984, respectively ( P < 0.0001). RESULTS: For hyperplastic polyps the pooled ORs with 95% CI were 3.557 (2.587-4.891) by fixed effects model and 3.703 (2.565-5.347) by random effects model. Their symmetry was estimated by the adjusted rank correlation test. Heterogeneity between studies was evaluated with the Cochran Q test whereas the likelihood of publication bias was assessed by constructing funnel plots. Pooled estimates were obtained using either the fixed or random-effects model as appropriate. METHODS: Extensive English language medical literature searches for human studies, up to December 2007, were performed using suitable keywords. AIM: To examine the risk of colorectal neoplasm in acromegalic patients by meta-analyzing all relevant controlled studies. ![]()
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