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Published on: September 15, 2017
Cancer incidence in endogenous hypercortisolism
Sinem Başak Tan Öksüz1,2, Mert Elitok3, Cenay Okyar3
1Faculty of Medicine, Division of Endocrinology and Metabolism, Ankara University, Ankara, Türkiye. sbtan@ankara.edu.tr.
Journal of Endocrinological Investigation
|August 13, 2026
Summary
Patients with endogenous hypercortisolism, including Cushing's syndrome, have a significantly higher risk of developing cancer. This increased cancer risk, particularly for thyroid cancer, highlights the need for ongoing oncologic surveillance.
Area of Science:
- Endocrinology
- Oncology
- Internal Medicine
Background:
- Endogenous hypercortisolism, encompassing Cushing's syndrome and mild autonomous cortisol secretion, is a condition of excess cortisol.
- Limited evidence exists on the association between endogenous hypercortisolism and the risk of developing new (incident) malignancies.
Purpose of the Study:
- To evaluate the cancer risk across the spectrum of cortisol excess.
- To identify predictors of malignancy in patients with endogenous hypercortisolism.
Main Methods:
- A retrospective single-center cohort study included 347 patients with endogenous hypercortisolism.
- Incident cancers were identified and compared to national cancer incidence rates to calculate standardized incidence ratios (SIRs).
- Cox regression analyses assessed predictors of incident cancer.
Main Results:
- A total of 42 incident malignancies (12.1%) were diagnosed during follow-up, a significantly higher rate than expected (SIR 3.42).
- Increased cancer risk was observed across all forms of endogenous hypercortisolism, including overt Cushing's syndrome (SIR 5.12) and mild autonomous cortisol secretion (SIR 2.68).
- Thyroid cancer was the most frequent malignancy, but excess risk persisted even after its exclusion (SIR 2.52).
Conclusions:
- Endogenous hypercortisolism is associated with a substantially increased risk of developing incident cancer.
- The risk is particularly elevated in overt Cushing's syndrome.
- Long-term oncologic vigilance is recommended for patients with endogenous hypercortisolism.
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