To the Editor: We disagree with the arguments put forward in the Commentary by Dr Perls and colleagues1 to oppose the widespread use of GH replacement for elderly GH deficiency (GHD). First, the authors suggest that GH replacement is associated with substantial adverse effects. Wuster et al demonstrated that such adverse effects may be due to overdosing and can be avoided by reducing the dose of GH by 50%.2
Second, a central point of Perls et al is that GH may cause cancer in humans, but this has never been proven. In a cohort study, GH replacement used in children treated for a malignant brain tumor was associated with a decrease in tumor recurrence by 40% and overall mortality rate by 50% in the first 5 years after diagnosis.3 The use of GH in adult patients with malignant gastrointestinal tumors did not increase tumor recurrence or decrease mean survival time.4 In a cohort study of adult patients who were GH deficient and initially free of cancer, the absence of GH treatment was associated with a doubling of the cancer incidence and was associated with an approximately 4-fold increase in cancer mortality compared with the general population.5 In contrast, in the patients receiving long-term GH replacement (60 months), the overall mortality and rate of malignancies were similar to those of the general population.
Financial Disclosures: Dr Dalle is president and Dr Claude is secretary of the European Organization of Scientific Anti-Aging Medicine, Paris, France.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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